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Staartsäit / Albumen / Schlagwierder Medicaid
+ Heritage House 5
ADAPT (628)
Edition USA/Colorado ADAPT seeks home care for all by Kerri S. Smith A national disabled persons’ advocacy organization based in Denver has launched a campaign aimed at moving people from nursing homes to home care. American Disabled for Attendant Programs Today (ADAPT) has at short-term goal: to re-direct 25 percent on the government's annual nursing home care budget. That money—estimated at $5.5 billion federal money and $5.5 billion from state coffers-would fund a national home care program instead. Under the ADAPT proposal, nursing home residents whose care is covered by Medicare or Medicaid could live at home. The government would pay home are attendants to care for them, rather than paying the facility. ADAPT spokesperson Mike Auberger said the group seeks “the ultimate demise of the nursing home system," and contends that paying an attendant to provide home care for a person usually costs less than nursing home care. In theory, the ADAPT plan would spend government money more efficiently-the same money would be used to care for more people who need assistance. The government is not enthusiastic about the idea, and a local nursing home industry spokesperson said ADAPT's demands are unrealistic. Auberger said Health and Human Services secretary Louis Sullivan declined to meet with ADAPT representatives. "We've been going back and forth with them, and the outcome is he doesn't meet with radical groups," Auberger said. And Arlene Linton, executive director of the Colorado Health Care Association (CHCA), said moving nursing home residents out of facilities “would isolate many of them from the community. “They'd also be without the 24-hour-care and rehabilitative services provided in nursing homes," Linton said. CHCA is the local branch of the American Health Care Association, which represents the nursing home industry. Linton added that ADAPT "is talking dollars, not people. Some residents have outlived their family and friends, and need the support a nursing home offers." A national campaign to publicize ADAPT's proposal began Jan. 15. Members demonstrated at government offices (including Health Care Financing Administration offices) and nursing homes in 24 cities. Auberger said media coverage was minimal, due to the Persian Gulf Crisis. Locally, ADAPT representatives demonstrated in Lakewood at Bethany Care Center. In the mid-'70s, the facility was operated by different owners and was known as Heritage House. Conditions at that time sparked a 13-year lawsuit over nursing home residents’ rights. The Federal Omnibus Reconciliation Act (OBRA) of 1988 also addressed quality of life issues for nursing home residents. The bill became effective Oct. 1, 1990. ln 1974, former Heritage House residents joined with Denverite Wade Blank and others to form the Atlantis Community, a local home care agency that currently cares for 135 people in Denver and Colorado Springs. Later, Atlantis Community leaders founded ADAPT. The group mobilized the civil rights movement for disabled persons, and ultimately affected the way nursing homes are inspected and regulated nationally. Auberger claims many current nursing home patients don't require intensive medical care, and "end up there only because they're out of money or their families can't care for them." Linton said CHCA met with ADAPT representatives twice to discuss the attendant proposal, "but they rejected our request to form a task force to find common ground." While Linton endorses home care as “a part of the long-term care continuum," she called the ADAPT proposal “robbing Peter to pay Paul. "We cannot support the concept of lowering funding for nursing home patients, to set up another funding to attendant services," Linton said. “We need new, additional funding for that." Recent federal budget cuts may make additional funding unlikely, at least in the near future. Atlantis and ADAPT are determined, however, and they are prepared for a long campaign.
ADAPT (45)
Rocky Mountain News Mon., March 22, 1976, Denver, Colo. Banner Headline for story. PHOTO on left of headline: Head and shoulders shot of a young man (Michael Smith) with dark hair, pulled back in ponytail, dark beard and moustache. His head is tilted slightly to one side and he is smiling a bit. Caption reads: Michael Smith. He had a dream; He prayed that He would walk again someday. But someday never came. [Headline] Late poet a plaintiff in nursing home case Page 5 [Banner headline in ADAPT 44. Story starts here in ADAPT 45 and continues in ADAPT 46, but the entire text is included here for ease of reading.] Late poet was plaintiff in nursing home lawsuit By Jonathan Dedmon, News Staff Michael Smith was a poet. A victim of muscular dystrophy, Michael wasn't able to hold a pen, however. Weighing less than 100 pounds, one of the few physical tasks he was able to perform was to turn the pages of the many books he read. He would keep stanzas of poetry stored in his head and wait for friends or staff at the Heritage House Nursing Home in Lakewood where he lived to have free time so he could dictate his verse. A former aide remembers when she would be busy caring for patients and Mike would say, "Got to write." "We'd say, ‘Sorry, Mike‘ Don‘t have time.‘ A lot of his poetry was lost." In addition to being a poet, Mike also was an idealist. Because of what friends say was that idealism, in spite of the fact Mike died in October at the age of 21, he lives on not only in a published book of his poems but also in a giant legal battle in U.S. District Court. THE BATTLE COULD have a large impact on the care of handicapped patients in nursing homes throughout the country since it attacks the entire method of delivering health care. The suit, in which Mike was an original plaintiff, charges nursing home patients routinely are being denied their rights and even fundamental medical care, contrary to the wishes of Congress in its Medicaid law. U.S. Judge Richard Matsch currently is considering how much jurisdiction the federal court has in the case. But already a number of patients and nursing home employees have come forward with a series of affidavits which are a litany of patient abuse. The charges are leveled primarily against the former Heritage House Nursing Center in Lakewood, which since has been sold and is operating under new management and a new name. The suit’s allegations range from patients not having the colostomy bags changed to failure of the staff to provide any rehabilitation efforts. THE NURSING HOME attorney and a part owner deny the charges which are contained in a half dozen affidavits filed with the court. Pam Malpass worked as an aide from August 1974 to February of last year. Here are parts of her affidavit: “People were punished sometimes by having their wheelchairs turned off, cut their mobility (sic). Wheelchairs at Heritage House were constantly in disrepair and falling apart leading to weekly crises. Paul Brae, a Heritage House resident, fell out of his chair because it was falling apart and crawled under his bed and said he was (sic) [not] going to come out until he got a new wheelchair [cut off] we procured for him with some difficulty. Bowel programs for a number of residents weren't maintained properly resulting in infections. Colostomies and catheters weren't cleaned properly or regularly also resulting in infections for a number of patients. I also often observed that colostomy bags and catheters improperly were connected to the people that needed them with the result that they leaked and backed up." Michael Ray, an orderly from May 1974 to January of last year, said in his affidavit that on at least a dozen occasions, he made marks with a felt-tipped pen on patients’ dressings on open bed sores to make sure they were being changed twice a day as they should have been. “Each time when I looked, a day later, sometimes longer, the dressings I had put on with the markings were still there. The unclean sores lead to more serious complications and infections. During the six months I was working at Heritage House I never saw a doctor." FAILURE TO MAINTAIN a bowel program can lead to bowel poisoning and even to surgery. Mark Biles was impacted for three weeks while I was there necessitating an elaborate program of oral laxatives, suppositories and enemas to give him relief. The owners and the administrators always met suggestions or requests from the staff on behalf of patients residing there with the remark that they cost too much or if you don't like it why don't you get the hell out. “The only time that Heritage House was concemed about the cleanliness of the home was when the state inspection team announced it would appear.” ACCORDING TO JOHN Holland, who heads a team of Legal Aid attorneys working on the case, “We're saying that when Congress established Medicaid, it intended to create a real system of delivering high quality medical care to poor people, not a system that couldn't deliver for a significant number. The benefits aren't getting there.” A particular target is the U.S. Department of Health, Education and Welfare (HEW), which is charged with making sure nursing homes comply with federal standards to insure high quality health care. Legal Aid, which is reluctant to say too much about the case because it is pending, feels HEW merely established a “paper compliance" system whereas Congress wanted a compliance system to “see benefits and rights delivered and prevent the kinds of injuries and deprivations of rights alleged in the suit." THE SUIT NAMES every rung in the bureaucracy which participates in the provision of nursing home care, ranging from the owners of Heritage House to the state Department of Social Services and HEW. In addition to asking for monetary damages, the suit also seeks an injunction prohibiting deprivation of medical care and patient rights. The rights include proper medical and psychosocial treatment and care, the right to seek legal counsel and manage personal monies, the right to voice grievances and the right to adequate notice and opportunity for a hearing prior to transfer, among others. It also asks HEW to come up with a decent system of enforcing compliance with such federal laws. Because of the complex nature of the suit, it already has become a “paper nightmare," according to Holland, and a “paper war,“ according to Heritage House attomey Bob Eberhardt. THE PLEADINGS STAND some two feet high and the court hasn't decided jurisdiction yet. Perhaps one of the most damning affidavits filed so far is by Janice Jacobson, a former administrator of Heritage House. “Heritage House was filthy, cockroaches had infested the entire home (with the exception of the kitchen). The walls wene very dirty and an odor of urine permeated the air. “Flies were everywhere. They present a particular problem to those persons who are bedfast or paralyzed because they can't swat the flies from their faces or bodies. “Temperature controls were broken. Zone control valves which control the room temperature were corroded either open or shut so that the rooms were unbearably hot or cold. “INDIVIDUAL CARE PLANS are either totally inadequate or not existent." “Patients who had to be fed were degraded by impatient orderlies who constantly hurried them along faster than they could comfortably go on the pretext of there not being enough time to feed them." “Staff would get angry with people for having something wrong with them like uncontrolled bowels." “Lots of patients would never get dressed every day. The staff didn’t like to take the time to dress them. By keeping patients undressed a general institutional goal of keeping them in bed and more inactive was more readily achieved. “It was not uncommon for people who did get dressed to not be undressed but rather to sleep in their clothes. l received complaints from one family that one of the male patients there had the same clothes on for weeks. They knew because the same spot was on his shirt for three weeks." “Visitors and relatives often complained that their relatives or friends hadn't received baths or showers for weeks." “It was reported to me by nursing staff the director of nursing believed physical correction of resident misconduct was permissible and that she employed a technique of having persons she decided were misbehaving placed in cold showers." “The call button system at Heritage House often wasn't working and when it was, working staff very often didn't respond to calls. There was one incident while I was there where family members called in and said they heard their mother was dead. The nurse had to go down to the room to see if this was so. The woman had been dead for several hours." Mrs. Jacobson says, in her view, Heritage House was “warehousing people, not delivering health care." "Residents had no more rights than children and the official view was that the staff knew what was best for them and if the patients didn't think we were doing everything right or what they needed they could just leave." Management expressed this view often. “PATIENTS WERE KEPT tractable and quiescent by intimidation and medication. Encouraging people to be as normal as they can be is the essence of good nursing care. It was not done at Heritage House.“ In response, Heritage House attorney Eberhardt said the accusations are “totally untrue and completely without foundation. You can't cross-examine affidavits. The truth will come out in the trial. “ He also points to the affidavit of Allen Buckingham, regional director of the HEW office of Long Term Care Standards Enforcement. Buckingham stated his office never received any complaints concerning the allegations. Oscar Gross, former part owner and also a defendant, said he never would have been able to keep his license if the allegations were true. In addition, he said his home was the only home to provide a wing specifically for handicapped youths and he even received two awards from the wing. “We tried to do our best," he said. He also offered to take the News to the home to interview patients about conditions. He said his wife still visits patients. Gross sold the home in February and it now is under new management. Gross said he sold the home simply as “a business transaction.“ Before Michael Smith died last year, he testified at one hearing on the case. “He already felt he had won," recalled Mrs. Malpass.
ADAPT (31)
[Headline] Heritage House Sued: Funds Violations Charged by Linda Cayton Attorneys for the Senior Citizens Law Center have filed suit in U.S. District Court charging the administrator and owners of Heritage House Nursing Care Center in Lakewood with illegally misappropriating and withholding personal needs money of patients, inadequate care, and intimidating and threatening residents who seek legal counsel. Officials of the Department of Health, Education and Welfare; Colorado Department of Social Services; and the Colorado Board of Health were also named as defendants for failure to enforce federal and state regulations governing nursing homes. The civil action represents a class action suit prompted by complaints received by the Legal Aid Society from the chief plaintiff, Patrick Smith, a 20 year old multiple sclerosis patient. Smith, a Medicaid patient, receives $25 per month from the Federal Supplemental Security Income (SSI) program to cover his personal needs. Early this year, Smith suffered a total respiratory breakdown and entered a local hospital. According to facts set forth in the lawsuit, while Smith was hospitalized, Thomas O'Halloran, administrator of Heritage House, instructed a bookkeeper to forge an “x” on Smith's SSI check. The check was endorsed, cashed, and credited to Smith's personal needs account. When Smith returned to the nursing home, O'Halloran informed him that his SSI check was unavailable. Later, Smith was informed that his check had been endorsed and cashed. Smith filed a complaint with the Legal Aid Society concerning the forgery. When attorneys informed O'Halloran of the complaint, he confronted Smith, calling him "despicable" and “ungrateful," and issued a week's eviction notice to him. Later, Smith's calls for nursing assistance went unanswered for some time and he was denied access to his medical files. In April, O’Halloran met with Assistant Colorado Attorney General Tony Accetta. According to Accetta's signed affidavit, O’Halloran admitted authorizing the forgery of Smith's signature in the belief that Smith would die before returning to Heritage House. O'Halloran also admitted circulating a memo stating that he did not “welcome harassment and threats from the legal profession” and explained that he threatened Smith with eviction because he did not want lawyers going through patients’ records. The suit charges O’Halloran and the owners of Heritage House with violating the Fifth and Fourteenth Amendments to the U.S. Constitution by depriving patients of the rights to manage their monies, to seek legal counsel, to adequate and proper medical and psychosocial treatment and care, to timely and adequate notice and opportunity for a hearing prior to a transfer from the facility and to access to their medical files. Casper Weinberger, Secretary of the Department of Health, Education and Welfare; Henry G. Foley, Executive Director of the Colorado Department of Social Services; and Edward Dreyfus, Director of the Colorado Department of Health were charged in the lawsuit with non-enforcement of the U.S. Constitution and those laws applicable to skilled nursing facilities. According to federal regulations, a nursing home patient should either manage his personal financial affairs or be given a quarterly accounting of financial transactions made on his behalf; be encouraged to exercise his rights as a patient and as a citizen with the right to voice grievances and remain free from reprisals; and be transferred or discharged only for medical reasons, or for his welfare, and be given advance notice of the transfer. State officials are charged with refusing to revoke or enforce Medicaid agreements or licenses of nursing homes that violate patients’ civil rights or provide inadequate care; inspecting nursing homes only once a year and giving prior notice of those inspections to the facility; and refusing to establish procedures for the management of patients’ personal needs money. Owners named in the civil action are Oscar Gross and H. Sol Cersonsky, general partners of Heritage House Associates; and Jack D. Feuer, a limited partner of Heritage House. Also named are limited partners M.J. Beitscher, Harry Berman, Bernard Ceronsky, Louis L. Fox, Howard D. Greyber, Martin Gross, Soloman Gross, Arnold Heller, Barry B. Melnick, Manuel Nash, and Johnny M. Weinreich.
ADAPT (27)
[Headline] Handicapped Pin Hope on Atlantis By Sharon Sherman Denver Post Staff Writer The word "activist' once scared a group of young Handicapped Denverites. But after almost two years of wheeling themselves onto picket lines, sitting through meetings with government agencies and speaking out about the problems of being shunted out of the mainstream of society, they agree that the term activist describes what they have become. And they are proud of it. "At least we're actively trying to do what we can instead of sitting back and wishing', is the way Carolyn Finnell, 31, sees the new role of many physically handicapped young people. [Subheading] Buses for Handicapped Carolyn, and others like her in the handicapped community, helped convince the Regional Transportation District to begin adding buses equipped for the handicapped. They have testified at various hearings about problems of the disabled. [TEXT UNREADABLE] They are among the principal planners of the Atlantis Community, a project which would offer the physically handicapped many types of residential living arrangements with services they need available nearby. Carolyn, who has cerebral play which confines her to a wheelchair and distorts her speech, said it was hard to "face speaking out" to rooms full of strangers, but that living with other young adults at Heritage House Nursing Home youth wing has "brought me out a lot." [Subheading] Stayed Inside Shell If Mike Smith, 20, had had his way, he would have stayed inside his shell of poetry writing, reading, and discussing philosophy and listening to music. "I don't like being in politics, but it seems that's the way we have to go,'' Mike explained. " I guess you have to lose a little to get a lot.'' Linda Chism, 27, believes that for the first time, there are enough young disabled people ready and willing to push themselves forward, to speak out, that there is a chance of changing the entire lifestyle of the handicapped. For Mike Smith, those changes may come too late to be enjoyed. [Subheading] Depressed, Angry Mike has muscular dystrophy, a fatal disease. He has spent the past five years in nursing homes, living in one where, at 15, he was punished for breaking rules and being sent to the locked ward for 24 hours at a time. Finally, lonely for friends his own age, depressed at watching his elderly roommate die of cancer, angry at rules which confined him to the small world of the nursing home, Mike attempted suicide. "Luckily, I had no idea how to go about it," he remembers. "I took 20 bowel softener pills and instead of dying just created an incredible mess." For Mike, as for Carolyn, the youth wing at Heritage House is infinitely better than what they had before. But, Mike points out, once the first door that closes any human being away from the rest of the world is opened, that human being will see other doors to open. So it has been for Carolyn, who counted fishhooks for five years in a sheltered workshop before someone recognized her potential. [Subheading] Wants Meaningful Job Now, with a degree in journalism from Community College behind her, Carolyn wants some other things she's not getting out of life. Things like a meaningful job, an apartment of her own where she won't have to keep half her belongings in boxes under the bed, the privacy to entertain friends. "I'm probably living a more active life than I ever have before", she said, explaining that she now edits the youth-wing newsletter and is learning braille so she can tutor blind students. Having come so far, Carolyn's not willing to stop here. Neither is Linda Chism, who has had crippling rheumatoid arthritis for 20 years. Linda has "suffered a lot of surgery and a lot of hard, hard therapy" to become fairly mobile. She has taken three years of courses in biology and psychology at the University of Colorado. She was even offered a full-time job. [Subheading] System Inflexible But the system doesn't allow even the disabled who are capable of supporting themselves to do so, Linda said. If she was paid even minimum wage, she would earn too much and would lose her Social Security benefits. But it would take much more than a minimum wage salary to pay living expenses plus the $150 a month it would cost her to get to work and back. In addition, she would no longer receive Medicaid assistance, and medical bills for someone in Linda's condition are enormous. "Who's going to pay a beginner with no experience that much money?" she asked. [Subheading] Innovative Projects For now, for these and other physically handicapped young adults, the boundaries of their world still don't go far beyond the nursing home walls. But those boundaries will expand dramatically if the young disabled can find support for two innovative projects. One is Project Normalization, a one year pilot study to find out what services young people in nursing homes need to live as normal a life as possible. The project would be conducted at the young wing of Heritage House and is estimated to cost $241,872. The state Department of Social Services has suggested that the pilot project be run by the Department of Physical Medicine of the University of Colorado Medical School. Members of the department now are investigating that possibility. [Subheading] Denied Normal Life "Disabled people are often denied any resemblance of a normal life," the project introduction says. "Because of the segregation they encounter, and the sheltered nature of their early lives, when they reach young adulthood they are incapable of functioning satisfactorily in society and so are banished to nursing homes where the repressive, nonstimulating and socially undemanding environment serves only to multiply their social inadequacies and further depersonalize them. As its creators see it, Project Normalization would begin to to prepare handicapped young adults for the kind of independent living they hope Atlantis will someday offer. [Subheading] Create a Community Atlantis is an ambitious project, planned by a group of both handicapped and able bodied persons, which would create a community of residential units surrounding a hub housing medical, rehabilitative employment, counseling, homemaker, transportation, food and social services. The goal of the community will be to "provide needed services while respecting the individual resident's freedom and privacy," according to the project booklet. For some of the prospective tenants of Atlantis, that goal can't be realized too soon. "I just sort of wish they'd hurry, " said Mike Smith. "Some of us have fatal diseases, you know, I only have two or three years to wait. "
ADAPT (22)
Charismatic Figure Absent - The Denver Post - Friday, August 2, 1974 PHOTO Denver Post photo by Bill Peters: Two thin young men with longish hair wearing sleeveless shirts sit facing a desk in front of them. On the other side, an older man with glasses in shirt sleeves and a tie (Gov. Vanderhoof) faces the two and the camera. One of the guys in wheelchairs has a poster-sign on the back saying "The handicapped are people too! Support [unreadable] RALLY!!! [unreadable]. Caption reads: Gov. John Vanderhoof talks with Gary Van Lake and Vic Stifel. The two men were in group of handicapped persons who visited the governor Thursday. [Headline] Wheel-Chair Group Gets Capitol Sympathy by Rykken Johnson A group of handicapped persons in wheel chairs looking for a “charismatic” figure to champion their cause for better care didn't find one in the governor’s office Thursday. The group, called The Organization of Disabled Adults and Youth (TODAY), met with a shirtsleeved Gov. John Vanderhoof for about 40 minutes to discuss problems faced by handicapped individuals and ways to reduce the difficulties. TODAY asked Vanderhoof for his support in channeling more state funds to improve staff and facilities at nursing homes and institutions for physically, mentally and emotionally handicapped persons. [Subheading] SYMPATHETIC EAR The governor listened solemnly, said he sympathized, reported that the state has been making strides for handicapped persons and will continue to do so, thanked the group for coming and told its members to drive carefully on the way home. None of the wheel-chair visitors as much as smiled at the sendoff from the governor's office. Outside, a couple of them replied with a flat no to a question if they thought they had found a leader for their cause. The meeting with Vanderhoof concluded a two-day rally by about two dozen individuals in wheel chairs from Heritage House and other nursing homes. The rally took place in front of Services, 1575 Sherman St., and the State Capitol. The organization, through seven members who met with Vanderhoof, didn't help its efforts by tying its plea to the employees’ strike at the Colorado State Hospital in Pueblo. Vanderhoof and other state officials have been battling with the strikers and their union for more than a week over pay for the state hospital staff. Although the state gained a court injunction on grounds the strike is illegal, some hospital employees Friday were still observing the walkout. TODAY spokesman Vic Stiefel, 29, told Vanderhoof that TODAY backs the strikers because the organization feels staffing is inadequate and pay too low at state institutions and that state reimbursement through state-administered Medicaid is too skimpy for private nursing homes like Heritage House to be effective. But the governor couldn't make the connection between pay and reimbursements, saying the dispute in Pueblo is a budgetary consideration and the nursing home difficulty a welfare consideration. Furthermore, Vanderhoof said, the state has made a “tremendous movement” to overcome architectural barriers against disabled persons and also is trying to influence the federal government to loosen its guidelines on Medicaid. The governor continued that under his program to restructure state government he is trying to get the state to deal more effectively with problems of the handicapped. [Subheading] 'NOT FAR ENOUGH’ Vanderhoof said the state "has come a long way over the last 8-10 years, but we haven't come far enough or fast enough". He said he would "pledge himself to problems of the handicapped. “We are moving in the proper direction but it's not going to happen overnight", he added. Later, in the governor‘s office, Wade Blank, a Heritage House employee who accompanied the disabled individuals said TODAY members were enthusiastic about chances that Vanderhoof will support “a good medical program." Blank disagreed that pay at institutions and reimbursements at nursing homes aren't connected, as Vanderhoof contended. "No matter what he says,” Wade said, “the state sets the reimbursement rate for the money a home gets.” He said one of the major problems at homes is that staff pay is low, that it doesn't go up very fast and that aides "burn out” in a few months and leave.