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FRIDAY | JULY 3, 2009
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Neglected to Death | Preventable deaths in nursing homes
Nursing home patients are dying from causes like malnutrition, dehydration and bedsores -- causes that could be prevented with proper care. But such cases are rarely investigated or prosecuted, and advocates say the suffering won't end without an outcry for reform.

Day 1 -- Nursing homes are killing thousands
Nation's nursing homes are quietly killing thousands
Patients are dying of causes that are preventable with proper care - and such cases are rarely investigated or prosecuted. Advocates say the suffering won't end without an outcry for reform. [more]
Survivors of lost loved ones tell stories of broken trust
They are victims of poor care in nursing homes, a cross section cut from the fabric of America - mothers and fathers, war heroes and homemakers, black and white. [more]
Day 2 -- Inadequate staffing results in patient neglect
Woefully inadequate staffing is at the root of patient neglect
Nursing homes don't have enough people to provide even basic care, and the job often falls to low-paid, low-skilled workers. And when quality employees do come along, they often don't stick around. [more]
Inadequate Medicaid payments squeeze homes' level of care
Some tie low staffing to drive for profits; reimbursements fall short, industry counters. [more]
Operator has toiled to rescue troubled home in University City
The state called on Sharo Shirshekan to save the newly named U-City Forest Manor. His orders were to bring the home's budget under control and correct chronic care problems. At one point facing closure, he persuaded the state to give him a chance - and now he has given the home just that. [more]
Day 3 -- Neglect can continue even after death
Many nursing home patients are neglected even after death
Police and prosecutors are reluctant to pursue criminal cases, partly because they are difficult to prove. And with little involvement from medical examiners, most misdeeds are buried with the dead. [more]
Fraud units employ the element of surprise in protecting elderly
Throughout the country, small groups of federal and state investigators are protecting the vulnerable elderly from wrongful deaths in nursing homes by using midnight raids and a Civil War-era law. [more]
Army of advocates keeps up the pressure for reform
Violette King is buzzing around her home office in Godfrey searching through photos and cluttered files detailing nursing home abuse when a ringing telephone interrupts. [more]
Day 4 -- Regulators are losing the fight against neglect
Ombudsmen often feel powerless in efforts to blow the whistle
In 1972, Congress passed a law that legislators believed would help end deadly care in America's nursing homes. It mandated that each state set up an ombudsman program to identify and investigate complaints in hopes of preventing the neglect and abuse that were harming the elderly in the facilities paid to care for them. [more]
Regulators are losing war against neglect, if they're fighting at all
Missouri officials acknowledge failings in their ability to protect residents. Their counterparts in Illinois see no significant problems despite complaints from inspectors. [more]
Day 5 -- Legislative efforts try to make things better
Inadequate laws are blamed for lack of prosecution in 4 heat-related deaths
When four elderly women baked to death from soaring temperatures in a University City nursing home in April last year, public officials expressed outrage and vowed to take swift action against those responsible. [more]
Nursing home industry wields clout in state capitals
More than 40 percent of the nearly $2.6 million the nursing home industry contributed nationwide in state elections in 2000 flowed into Missouri and Illinois. [more]
Congress renews an old battle for nursing home reform
The senior member of Congress wrapped his gnarled hands around the microphone sitting on the green felt-covered witness table and asked his distinguished colleagues: "What have the elderly in this country done to make their government and their neighbors so willing to have them starved, neglected and uncared for?" [more]
Day 6 -- An innovative program at St. Louis University
SLU physician has cure for ailing nursing homes
Almost everyone running a nursing home knows what causes the problems that lead to illness, death and lawsuits over bad care. Dr. John Morley, a nationally renowned gerontologist at St. Louis University, knows how to solve them. [more]
Innovative home lets people take control of their lives
Here is what Eric Haider says people dislike most about nursing homes: losing their privacy and losing control over their lives. [more]
Day 7 -- One family's decision
Planning and a grasp of options can ease the stress of uprooting a life
Experts strongly advise that advance planning, or, at minimum, some understanding of what's available to elderly people and their families, can ease the transition from independence to long-term care. [more]
Planning and a grasp of options can ease the stress of uprooting a life
When Mark Carroll began searching for a nursing home for his mother, Virgie Carroll, he had many advantages. [more]
Day by day he lost a little bit of her
After more than 50 years as man and wife, living together in the same house, bearing a son and raising him, Lawrence and Virgie Carroll all but shared each breath. [more]
Opinion
Finally, reform
JUST one week ago, meaningful nursing home reforms seemed destined for defeat in the Missouri Legislature. [more]
Wrecking reform
IT TOOK less than 20 minutes Thursday morning for a House committee to pass its package of watered-down “reforms,” leavened with millions of dollars of goodies for the nursing home industry. [more]
The longest mile
FOR an idea everyone claimed to support, nursing home reform has faced a mighty rough road through the state Senate. [more]
Nursing Homes : In defense of my mother's care
Her career was motherhood. She spent every cent on raising her children, not lavish living. Why should she be deined competent nursing home care? [more]
NURSING HOMES: Friends like these
FIRST there was "Reform Lite," Senate Bill 556, a watered-down compromise that was a modest improvement over Missouri's toothless and ineffective nursing home laws. [more]
Reform lite
LAST week, legislative leaders in Jefferson City unveiled a compromise reform bill to protect nursing home residents. [more]
NURSING HOMES: A ray of hope for reform
THOUSANDS of vulnerable nursing home patients die of neglect and abuse in this country every year. Officially, the causes are thirst, malnutrition or untreated bedsores. But the real killer is apathy. [more]
Protecting the neglected
IN theory, tort reform is a reasonable idea. No one wants to see frivolous lawsuits clogging the courts. [more]
NEGLECTED TO DEATH: The ghosts of Beverly Farm
LAST spring, within the span of a month, four people died at Beverly Farm, a nursing home in Godfrey, Ill. This month, the state health department fined the home $20,000. [more]
The ultimate weapon for nursing homes
ONE OF the most powerful tools for improving the nation’s nursing homes is information. More quickly than regulators and more sweeping than new laws, it can punish owners who put profits before patients. [more]
Commentary: Dementia patients need special help
At least half of all nursing home residents have Alzheimer's disease or another dementia. [more]
Commentary: Families must dare to care
Nursing homes know that the only thing that can hurt them is bad publicity; this why they want the finger-pointing to stop. [more]
Commentary: Put focus on patients not paperwork
Elder abuse is inexcusable, and those who break the public's trust should be punished to the fullest extent of the law. [more]
Commentary: To staff properly, pay
The articles and editorials in the Post-Dispatch regarding nursing home care in have prompted discussion of very fundamental issues regarding long-term senior care. [more]
Commentary: Require enough nurses and aides
Our company regularly goes into local nursing homes. We evaluate care, develop plans to improve situations and provide information on options. The system is broken. Until the general population demands changes, it will remain broken. [more]
War of words
GOV. Bob Holden had the right ideas. But he put them together this week in the wrong order. [more]
Rewrite the basic laws
The Post-Dispatch is correct in citing Missouri's nursing home laws as poorly written and outdated. But to say legislative leaders have not made nursing home reform a priority misleads the public about the real complexities of this problem. [more]
LETTERS TO THE EDITOR
Elderly abuse: Enough is enough [more]
Opinion: A cry for reform
THEY starve to death with food just out of reach. They die of thirst in rooms with running water. They rot from untreated bedsores. [more]
Multimedia
Gov. Bob Holden on nursing home reform
Gov. Holden on the Department of Family Services
Gov. Holden on proposed nursing home reform laws
Gov. Holden on demanding accountability from nursing home executives
Gov. Holden on handling administrative costs
Lt. Gov. Joe Maxwell on proposed violation penalties
Lt. Gov. Joe Maxwell on being an advocate for seniors
Download the free Realplayer plug-in. [more]
Slide shows
View photos from the series
View photos from the series
Outside sources
American Association of Homes and Services for the Aging
This site can provide tips for choosing facilities and services for the elderly. [more]
AARP
AARP provides a large variety of resources for people over 50. [more]
Action Pact
Action Pact's program Culture Change Now is designed to have nursing homes rethink the concept of caring for the elderly. [more]
American Health Care Association
This site includes consumer information about planning, preparing and paying for long-term care. [more]
Agency for Healthcare Research and Quality
This agency does research into what works and what doesn't work in health care. [more]
Alzheimer's Association
The St. Louis chapter of the this group helps people and families cope with this disease. [more]
American Medical Directors Association
Information about long-term care and the rankings of nursing homes can be found here. [more]
Administration on Aging
This agency, part of the Department of Health and Human Services, provides information on services and other needs. [more]
Centers for Medicare and Medicaid Services
This federal agency runs Medicaid and Medicare as well as a program that provides care for uninsured children. [more]
Missouri Department of Health and Senior Services
This is the state agency in charge of health-care information and programs for the elderly. [more]
Missouri Department of Social Services
Missouri's services for the elderly are coordinated by this department. [more]
Long Term Care Ombudsman Program
Representatives of this agency act as advocates for the rights of the elderly as well as a source of information. [more]
Missouri Coalition for Quality Care
This non-profit statewide organization pays attention to the care of older and disabled people getting long-term care in Missouri. [more]
Nursing Home Compare
This site from Medicare allows you to compare all nursing homes in the country that are certified by Medicare and Medicaid. [more]
MedWeb
This site, from Emory University, has a wide range of consumer and medical information. [more]
Mid-East Area Agency on Aging
Serving senior citizens on the Missouri side of the St. Louis area, this agency has programs such as the Silver Haired Legislature. [more]
Missouri Department of Mental Health
This government department provides help for people trying to screen potential caregivers. [more]
Quality Improvement Program for Missouri
On this site, you can find guides to quality care aimed at both consumers and providers. [more]
St. Louis County Older Resident Programs
This program has provided services to St. Louis County residents age 60 and over for more than 25 years. [more]
St. Louis Area Agency on Aging
This agency provides help for older city residents who need information on community-based services. [more]
United Way of Greater St. Louis
Elder care for senior citizens is one of many services provided by this agency. [more]
Nursing Home Monitors
Publicizes neglect and abuse in general and in specific nursing homes, educates legislators, physicians, discharge planners, the press and the public. [more]
Reaction and follow-up
Nursing homes face stricter rules
Motorists caught speeding or driving cars with broken taillights have to pay fines. Now, nursing homes that endanger residents' lives will, too.

Gov. Bob Holden used that analogy on Monday as he signed the Senior Care and Protection Act of 2003.

The law will give the state more authority to sanction homes that neglect or abuse residents. [more]
Senate OKs stricter nursing home rules
At 1:25 a.m. on April 8, 2001, paramedics found a woman dead in her stuffy, third-floor room at the Leland Health Care Center in University City. [more]
Nursing home bill draws praise
The Senior Care and Protection Act of 2003 aims to reward the good operators and shut down the bad ones, supporters said at a packed Senate hearing. [more]
Lawmakers are united on nursing home bill
Plan will help protect older adults, says bipartisan group of legislators. [more]
Bill targets abuse in nation’s nursing homes
Legislation that would provide nursing home residents the same protection against violence that the government now affords abused children and battered women was introduced Monday in the Senate. [more]
Lawmakers are united on nursing home bill
Plan will help protect older adults, says bipartisan group of legislators. [more]
'Triage' review is option in elderly deaths
When a child dies in the St. Louis area, an investigator gives each case a close look to determine the cause of death. But when an elderly person dies, those cases rarely draw any attention from a medical examiner's office. The result is that some deaths from neglect go undetected. [more]
Holden calls for action on nursing homes
Governor wants reforms to prevent deaths, toughen punishment. [more]