A new bill seeks to bolster emergency preparedness at the nation's nursing homes, even as the Trump administration backs away from some non-compliance penalties.
Reps. Debbie Wasserman Schultz (D-FL) and Tim Walberg (R-MI) are lead sponsors of a bill that would require nursing homes to have alternative sources of energy capable of heating, cooling and venting a building for at least four days in case of an emergency; prioritize nursing homes in the same manner as hospitals during public health emergencies; and authorize civil penalties up to $100,000 for non-compliance resulting in a resident's death.
Wasserman Schultz first proposed new rules in October, a month after 14 residents died from heat-related illness in a Hollywood, FL, nursing home days after Hurricane Irma knocked out air conditioning there.
At the time, she decried lax enforcement and said too many nursing homes accepted the cost of potential fines instead of investing in alternative power supplies.
The new bill was introduced Dec. 20, just days before a New York Times report noted the Trump administration had scaled back its use of fines against nursing homes with regard to resident harm.
“Now is not the time for Trump to roll back fines that noncompliant nursing homes face when they put our seniors in harm's way,” Wasserman Schultz tweeted, after the story hit.
A covered patio seems to be the starting point of the Nov. 16 five-alarm fire at Barclay Friends continuing care retirement community in which four residents died, according to Bureau of Alcohol, Tobacco and Firearms investigators. Agents remain unsure, however, of what caused the West Chester, PA, fire or how it spread, according to local media reports.
ATF spokeswoman Charlene Hennessy said the fire at the Kendal Corp. CCRC appears to be accidental but that the investigation is ongoing, CBS Philly reported on Friday. Agents also are conducting tests to see whether the sprinkler system was operating properly, Hennessy said.
The Chester County Coroner's Office previously identified the four deceased residents as Mildred Gadde, 93; Theresa Malloy, 85; and Delores Parker, 89, and her husband, Thomas Parker, 92. Twenty-seven additional residents were injured in the fire, according to the community.
In a message posted Thursday on its website, Barclay Friends said it continues to work with investigators to determine the cause of the fire and to work with residents, family and staff members to meet their needs. The community said it plans to hold meetings with families this week.
The CCRC said it plans to demolish the building where the fire broke out and that it hopes to reopen its skilled nursing building as soon as possible, although dates have not been set.
In the meantime, Barclay Friends staff members and volunteers are preparing “Secret Santa” packages for residents, according to the post. First Presbyterian Church of West Chester is helping to coordinate the effort; people can sign up to volunteer or donate here, if interested.
Source: McKnight's Senior Living
Recent fires in long-term care and senior housing buildings in Pennsylvania, Idaho and California stress the importance of fire safety and emergency preparedness in facilities that provide services to the elderly, sick and frail. While healthcare providers have spent a great deal of time and resources dedicated to the development of an “All Hazards” Emergency Management approach to preparedness within their operations, providers cannot forget to focus on the threat of fire as it is one of the most common perils within their community.
During the holiday season, it is critically important for individuals and organizations to maintain a clear focus on safety-related matters and to use common sense and good judgment when decorating their facilities in the spirit of the season. Here are some basic tips to remember to help ensure fire and life safety within a long-term care facility or senior living community:
It is imperative that all exits within a building are kept clear of any type of obstruction. Items like holiday trees, decorations or furniture that is rearranged to accommodate a holiday display should never compromise an exit or a pathway of egress. Do not let “seasonal design” impede exit access requirements. Such a condition represents a code violation and potential deficiency.
Two recent news stories may have you re-examining your emergency preparedness plans, especially as they pertain to fires.
Four residents died and more than 160 residents and staff members were evacuated, including more than two dozen residents who were taken to hospitals, during a five-alarm fire Nov. 16 at the Barclay Friends continuing care retirement community in West Chester, PA. Investigators are still trying to determine the cause of the blaze, which destroyed part of the community, forcing parent company Kendal Corp. to relocate residents.
In a Nov. 18 fire at Safe Haven Care Center, a former nursing home in Pocatello, ID, that was operating as an assisted living community and also included a psychiatric hospital, no deaths or injuries were reported. The building and all of its contents are gone, however.
The Idaho fire is believed to have started in the building's attic, where state law did not require a sprinkler system because it was unoccupied. Idaho operates under the International Fire Code and National Fire Protection Association codes, the state fire marshal told the Idaho State Journal. He added that he will be recommending a review of those codes to ensure that they protect people as much as possible.
As most employers probably know by now, OSHA’s revised recordkeeping rule requires certain employers to electronically file injury and illness data with OSHA. Originally the reporting deadline was July 1, 2017. OSHA has again extended the deadline, this time to December 15, 2017.
During the previous extension period, it appeared that OSHA might be reconsidering the rule, with a possibility of modifications or a complete revocation of the rule by December 1, 2017. However with the recent extension to December 15, it appears that the rule will remain unchanged for the time being and that covered employers must report by the new deadline.
As a reminder, establishments with 250 or more employees must submit information electronically from their 2016 Form 300A by December 15, 2017. These same employers will be required to submit information from all 2017 forms (300A, 300, and 301) beginning in 2018.
Establishments with 20-249 employees operating in what OSHA deems to be “high-risk industries” (including department stores, nursing homes, construction) must submit information from their 2016 Form 300A by the December 15, 2017 deadline. These same employers will continue to only submit information from their 300A forms in later years.
Although OSHA’s electronic reporting webpage experienced malfunctions earlier this year, the webpage now appears to be working.
For more information on this or any related topic please contact the author, your Seyfarth attorney, or any member of the Workplace Safety and Health (OSHA/MSHA) Team.
Source: Seyfarth Shaw LLP
Officials have recovered the remains of two people from what is left of a Pennsylvania senior living community following last week's fire.
The fire broke out Thursday night at Barclay Friends Senior Living Community in West Chester, west of Philadelphia. More than two dozen people were injured and 133 residents displaced.
Chester County District Attorney Tom Hogan said Monday four residents were still unaccounted for, including a husband and wife.
Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives located the remains Tuesday. They were transported from the scene by the Chester County coroner. The search will continue Wednesday for the two remaining missing residents.
None of the missing residents have been identified.
The origin and cause of the fire is still under investigation.
Source: AP News Archive
ABC World News TonightVideo (11/17, story 4, 1:25, Muir, 7.89M) reported that on Friday, a senior living facility near Philadelphia caught fire, which correspondent Eva Pilgrim said led to the "massive rescue" of "about 160 residents and employees." She added that authorities engaged "in a desperate search for those unaccounted for in the massive inferno that ripped through" the facility, and more than "400 emergency workers scrambl[ed] through the night to save the elderly residents," many of whom "couldn’t escape on their own." Pilgrim said the blaze was a "five-alarm fire," and that 27 residents were transported to area hospitals.
The CBS Evening NewsVideo (11/17, story 8, 0:20, Mason, 6.25M) reported that at least 17 residents have been hospitalized, adding that some residents "are still not accounted for." The Evening News added, "Investigators are waiting for the smoldering ruins to cool before they can search for the cause."
NBC Nightly NewsVideo (11/17, lead story, 2:00, Holt, 7.26M) reported that some of the hospitalized residents were injured "seriously" and that "at least 100 are displaced." Correspondent Kristen Dahlgren said, "Police won’t confirm how many are unaccounted for. But with more than 150 residents rescued, many are calling it a miracle."
USA Today (11/18, Michaels, 8.62M) reported it could take "several days before investigators can pick through the ruins." Charlene Hennessy, a spokeswoman for Alcohol, Tobacco and Firearms (ATF) said Friday, "No one at this point came forward and said we can’t account for a loved one." Another official "said there were no confirmed deaths."
NPR (11/17, Neuman, Wamsley, 2.4M) reported the fire took place at the Barclay Friends Senior Living Community in West Chester, Pennsylvania, adding that it "quickly spread to multiple buildings, according to The Associated Press."
The International Association for Healthcare Security & Safety (IAHSS) announces the release of a new industry guideline titled "Collaborating with Law Enforcement." This is a timely guideline as it was published just prior to a widely covered news event regarding a University of Utah Hospital nurse who was arrested for refusing to draw blood from an unconscious patient. The Emergency Nurses Association (ENA) reached out to IAHSS, and both organizations are supportive of working together to ensure a situation like this does not happen again.
Healthcare Facilities are responsible for providing a safe and therapeutic environment while respecting the rights and privacy of those entrusted to their care. IAHSS guidelines are intended to assist healthcare administrators in fulfilling their obligation to provide a safe, secure and welcoming environment, while carrying out the mission of their organizations.
The IAHSS Council on Guidelines is comprised of volunteer IAHSS members who are seasoned healthcare security professionals and leaders. Each year the Council on Guidelines develops new industry guidelines and reviews existing guidelines on a three-year cycle. All IAHSS guidelines are available electronically to IAHSS members via the IAHSS website. Hardcopies of the guidelines booklet are published annually and available for sale in the IAHSS online store. The new guideline, "Collaborating with Law Enforcement," can be accessed by the public for a limited time at www.iahss.org/guidelines.
Those in charge of the Hollywood nursing home where several residents died after Hurricane Irma struck have been served with plenty of lawsuits over the years.
"I've been suing them for 20 years," said Bill Dean, an Aventura nursing home plaintiffs lawyer. "There hasn't been improvement. There's been constant decline."
The tragedy at Rehabilitation Center at Hollywood Hills, which has resulted in 10 residents' deaths so far, led the state Agency for Health Care Administration to suspend its license Wednesday.
The agency found the residents who died after the facility's air conditioning went out had body temperatures of up to 109.9 degrees by the time they made it to the hospital across the street. Staff made late entries on patients' charts, and in one case reported a resident's temperature was taken at the facility when he had already been evacuated, according to the agency.
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Preparation for all types of emergencies and potential disasters is a familiar activity for senior living communities. However, the one event that is more difficult for communities to fully prepare for is an active shooter event. Senior living communities know that they are not immune to this threat, yet most do not have plans or training to guide their responses to save lives should this occur.
In order to help address this serious risk the Willis Towers Watson Senior Living Practice, in partnership with Sorensen, Wilder and Associates, developed an employee training video–The Four Outs. The Four Outs – Get Out, Hide Out, Keep Out and Take Out, represent the critical action steps to take when faced with an armed intruder/active shooter situation.
You will find in the upper right corner of this page additional materials, such as sample policy and procedure guidelines. A readiness assessment/checklist and poster are also available for those who may need supplemental resources for a comprehensive plan and program.
The Federal Emergency Management Agency (FEMA), in coordination with the Federal Communications Commission (FCC), will conduct a mandatory nationwide test of the Emergency Alert System (EAS) on Sept. 27, 2017 at 2:20 pm EDT. The test will assess the readiness for distribution of the national level test message, as well as verify its delivery.
The EAS test is made available to radio, television, cable and direct broadcast satellite systems, and is scheduled to last approximately one minute. The test’s message will be similar to the regular monthly test message of the EAS with which the public is familiar, only inserting the word “national.” “This is a national test of the Emergency Alert System. This is only a test.”
A Massachusetts behavioral health facility faces $207,690 in proposed penalties from the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) for violations found while conducting a follow-up inspection.
It is a harsh reminder of how critical a well-developed, well organized workplace violence prevention program is, and how much it must be trained on and practiced.
Our Essentials of Aggression Management in Healthcare program helps meet one of OSHA’s most critical requirements…being trained to recognize and defuse aggressive behavior before it becomes violence. And, ours is the only program written by healthcare professionals for healthcare professionals, and incorporating patient rights as part of the training curriculum.
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Water poured into hospitals. Ambulances were caught up in roiling floodwaters. Medical transport helicopters were grounded by high winds. Houston’s world-renowned health care infrastructure found itself battered by Hurricane Harvey, struggling to treat storm victims while becoming a victim itself.
The coming days will inevitably bring more hazards for storm-damaged hospitals and nursing homes, and their patients and staff. The scenes of turmoil across Texas raised the specter of the extreme flooding following Hurricane Katrina in 2005, when dozens of hospital and nursing home patients died, and doctors awaiting rescue at one stranded, powerless hospital became so desperate, they intentionally hastened the deaths of their patients.
The response to Harvey, now a tropical storm but still wreaking havoc over the state, promises answers to whether health officials learned lessons from the catastrophe of Katrina when it comes to the medically vulnerable — in particular whether they did enough to prepare for the disaster and to move patients out of its path.
“We’ve made significant investments,” Dr. Umair Shah, executive director of Harris County’s public health department, said in a telephone interview on Sunday. “The challenge is until it unfolds there’s so many moving pieces and it’s never the same as the situations you’ve previously encountered.”
Responders point to dozens of improvements, from better engineered structures to well-practiced cooperation, that are helping protect lives. Still, sometimes even the soundest plans have been foiled.
A nurse is leaving the skilled nursing facility (SNF) where she is employed. She’s met in the parking lot by her angry husband who is facing the custody loss of his children in a divorce. He shoots his wife in front of her co-workers and residents.
At another SNF, an intoxicated boyfriend shows up and attacks his girlfriend, an employee, in the parking lot, accusing her of cheating on him with a co-worker.
I wish I could tell you that these are scenes from a fictitious television series, but they aren’t. These are real incidents that occurred at real long-term care facilities against real staff members. And these are just a few of the many incidents we are aware of.
Domestic violence is quickly becoming a major concern for healthcare professionals. More and more, abusive spouses/partners are showing up at the healthcare facility, knowing that access is easy, usually unrestricted and sometimes not monitored by video security. This ease of access combined with the element of surprise often gives them the upper hand. And these events are not only a threat to the target employee, they also place every employee and resident at risk.
According to the Centers for Disease Control and Prevention (CDC), one in every four women and one in 10 men will experience domestic violence in their lifetime. The Department of Labor reports that victims of domestic violence lose nearly 8 million days of paid work per year in the United States, resulting in a $1.8 billion loss in productivity for employers. The CDC also reported that an estimated 1.3 million women are victims of physical assault by an intimate partner each year.
Yet, 65 percent of companies don’t have a formal workplace domestic violence prevention policy, according to research conducted by the Society for Human Resource Management(SHRM), and only 20 percent offer training on domestic violence.
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Older adults in nursing homes and other post-acute and long-term care (PA/LTC) settings are at increased risk for harm from disasters such as hurricanes or floods because they are frailer, generally have more illnesses and disabilities, and rely on medications and supports such as oxygen. During Hurricane Katrina, for example, elders accounted for approximately one-half of all deaths directly related to the storm. A new study in the August issue of JAMDA suggests that, if nursing home residents are evacuated during an emergency, they have a higher risk of death up to 6 months afterwards.
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A prosecutor says a northern Indiana man fatally shot a doctor because he would not prescribe opioid painkillers to the man's wife.
St. Joseph County Prosecutor Ken Cotter identified the gunman Thursday as 48-year-old Michael Jarvis of Mishawaka.
Police say Jarvis fatally shot 56-year-old Dr. Todd Graham on Wednesday in a parking lot outside the St. Joseph Rehabilitation Institute in Mishawaka.
Cotter says Graham declined to prescribe highly addictive opioids to Jarvis' wife during an appointment Wednesday morning. He says Jarvis returned to the medical center about two hours later and shot Graham.
Cotter says Jarvis then drove to a friend's home about 3 miles (5 kilometers) away and fatally shot himself.
Cotter says Jarvis's wife wasn't aware of her husband's actions.
Two skilled nursing employees were credited this week with rushing into "heavy smoke conditions" and pulling two occupants to safety, according to local reports.
The fire at Courville at Nashua was reported at 2 a.m. Sunday and contained to a second-floor room. One resident was taken to an area hospital for possible smoke inhalation, but he was expected to recover.
"They were two maintenance or housekeeping guys who were here on a special project. They just saw the smoke, ran into the room, got the residents, the gentlemen out of the room. It just worked perfectly," Courville Company President and CEO Luanne Rogers told television station WMUR. The 100-bed Courville at Nashua is part of Courville Communities.
Neither rescuer wished to be identified local officials said. More than half of the 90 residents were taken to a nearby Kindred facility while damaged parts of Nashua facility were under repairs.
Rogers credited preparation and dedicated staff for avoiding tragedy, telling the station that she had "the best staff on the planet." Fire officials also said automatic sprinklers contained the fire and that the cause was under investigation.
"The staff did everything they were supposed to do," Rogers told The Boston Herald. "It's one of the blessings of living in New Hampshire: If something happens, your peers step up. We had staff who heard about it and just came in and helped."
A 49-year-old East St. Louis woman was indicted earlier this week for allegedly torching a Cahokia nursing home, U.S. Attorney for the Southern District of Illinois Donald Boyce said.
According to court documents, the Cahokia Nursing and Rehab Center caught fire May 31, 2016.
Prosecutors allege Lori Jones, an employee at the facility, set fire to the building. More than 100 elderly patients had to be evacuated and relocated as a result of the fire.
Prosecutors did not disclose a possible motive for setting the fire.
Jones was charged with one count of arson.
If convicted, Jones faces between 5 and 20 years in prison, followed by 3 years of probation, and a $250,000 fine.
Source: FOX 2 NOW
The gunman in a shooting that left two Ohio nursing home employees and a police officer dead reportedly shot the facility's alarm system as he entered, leaving many employees unaware that he was in the building.
That's according to three nurse aides who spoke with a local newspaper last week. They're working to raise money to cover counseling sessions for employees of Pine Kirk Care Center in Kirkersville, OH.
“This is a nursing home, why does he have a gun?” nurse aide Mandi Moran recalled thinking as Thomas Hartless entered the facility on May 12.
Moran told the Newark Advocate she watched Hartless come down the hallway after shooting the alarm system, stopping it from alerting anyone that he had entered the locked facility.
The Centers for Medicare & Medicaid Services has published an advanced copy of interpretive guidance for its final emergency preparedness rule for healthcare providers.
The rule, issued last September, applies to all healthcare facilities and will be implemented on Nov. 15. Long-term care providers will have to meet additional standards under the rule, such as having emergency and standby power systems. They must also create plans regarding missing residents that could be activated regardless of whether the facility has activated its full emergency plan.
In a memo posted Friday, CMS shared an advanced copy of a new Appendix Z for the State Operations Manual pertaining to emergency preparedness. The advanced copy will “vary slightly” from the final version, CMS said.
The agency had previously urged providers not to put off planning their emergency training exercises until the guidance was released, noting that waiting for the guidance “is not necessary nor is it advised.”
“The interpretive guidelines and survey procedures in this appendix have been developed to support the adoption of a standard all-hazards emergency preparedness program for all certified providers and suppliers while similarly including appropriate adjustments to address the unique differences of the other providers and suppliers and their patients,” the memo reads.
CMS also stressed that successful adoption of the new requirements will allow all types of healthcare providers “to better anticipate and plan for needs, rapidly respond as a facility, as well as integrate with local public health and emergency management agencies and healthcare coalitions' response activities and rapidly recover following the disaster.”
Court records show the man authorities say gunned down an Ohio village police chief and two nursing home employees had a history of violence, including against the nurse who was among the slain.
The suspect, Thomas Hartless, 43, was found dead inside Pine Kirk Care Center.
Nurse Marlina Medrano, 46, nurse's aide Cindy Krantz, 48, and Kirkersville Police Chief Steven Eric Disario, 36, were killed in the Friday attack.
State and local authorities said Saturday the investigation was continuing and they had no new information to release on the deaths in the village of some 500 residents, roughly 25 miles east of Columbus.
Records show Medrano had obtained civil protection orders against Hartless. He was released from jail in April after his latest domestic violence case in March. He also served time for a 2009 abduction of another woman.
"I am afraid to be alone with him, that he will hurt me for good," Medrano wrote in her latest petition in May. The Columbus Dispatch reported that court officials said Friday that protection order was still in effect. Records show Medrano had reported injuries including a concussion and cuts requiring stitches.
The Dispatch reported that she had earlier told police he once showed her a hole he had dug and said he would put her in it if she didn't stay with him. She also told police Hartless "doesn't like police."
Hartless' neighbor, Connie Long, told reporters Medrano had taken shelter in Long's home March 6 after he attacked her. Long had posted a Facebook warning to the community that "a violent man" was loose after Hartless was released only weeks later.
Disario headed the Kirkersville Police Department for only about three weeks, Licking County Sheriff Randy Thorp said. He was the father of six children, with a seventh on the way, the sheriff said.
Residents in the community added to a growing memorial outside the police department Friday night, CBS affiliate WBNS-TV in Columbus reports. Darlene Ruff told the station it was the least she could do.
"He gave his own life to protect everybody and now his kids don't get to see their dad again," she said. "I remember he had given candy to the kids and it was just so sweet because he was new you know so, this is just our gratitude to say thank you for protecting all of us."
Authorities say the gunman had taken two passers-by as hostages in a wooded area behind the nursing home. Disario, responding to a report of a man with a gun, said in his last radio communication that he had the man in sight. The hostages escaped unharmed, as did all 23 residents of the nursing home.
Ohio Gov. John Kasich ordered that all flags be flown at half-staff at all public buildings and grounds throughout Licking County and at the Ohio Statehouse through sunset May 16 to honor the lives lost in "senseless acts of violence" in Kirkersville.
Source: CBS News
A police officer has been shot during an active shooter situation in Licking County, just east of Columbus.
According to NBC4i, the shooter was reported at the 200 block of E. Main Street at the Pine Kirk Care Center, a nursing home in Kirkersville.
An officer was shot while responding to the active shooter situation. The officer's condition is unknown.
Police say the active shooter situation has been "neutralized," according to NBC4i, though law enforcement will not elaborate on details.
NBC4i is live on scene. Watch video courtesy of them in the player above.
The nearby elementary school has been placed on lockdown, NBC4i reports. According to the Newark Advocate, Southwest Licking Local School District students were on buses when the situation started. Those students were reportedly taken to Watkins Middle School.
Medical helicopters were called to land at the National Trail Raceway. The Advocate also reports that U.S. 40 is closed in the area and is expected to remain closed for hours.
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Skilled nursing facilities (SNFs) and all other providers who are reimbursed by the Centers for Medicare and Medicaid Services (CMS) will be required to comply with new emergency preparedness regulations by November 15, 2017. The rules, approved in late 2016, include far more than having an emergency plan written down and stored on a bookshelf.
Evaluating providers for compliance will become part of the survey process, and any non-compliance must be rectified like any other deficiency, noted the Oct. 28, 2016 CMS announcement.
These significant changes in emergency preparedness regulations for CMS-regulated healthcare facilities have been a long time in coming. The highlights of the new regulations can be broken down into four specific areas of compliance that includes the following:
For the purposes of this article, I will focus on these elements of the new regulations as they pertain to SNFs. For additional clarification, CMS has developed a comprehensive table that further explains the requirements for each of the 17 provider types affected by these regulations.
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When a new C.E.O. took over a struggling aluminum company, he decided to focus on one surprising habit: worker safety.
Click here to view a short video that helps put "safety" in any type of organization into context.