Jacksonville, Florida — May 24, 2016  Today Forcura, a healthcare technology company focused on solutions that help healthcare providers run more effective and efficient practices, launches its second product, Forcura Messenger.

Forcura Messenger is a simple and intuitive secure mobile messaging app designed specifically for healthcare providers. It allows all members of a healthcare team to share secure messages, images and documents in real-time from any location and can be accessed via any device: smartphones, tablets and desktops. [Details are provided  about the Forcura Messenger app’s capability to communicate securely on mobile devices, and to securely integrate its data with the Forcura Workflow product.]


“Our customers, healthcare providers, have been asking us how their care teams could better communicate securely on mobile devices. SMS is not HIPAA secure. Today, we are excited to be able to respond with Forcura Messenger, which solves this very large healthcare compliance issue,” said Forcura CEO Craig Mandeville.

Forcura Messenger was developed in conjunction with several current Forcura customers who were looking for a solution to allow remote healthcare workers to capitalize on mobile technology while eliminating any HIPAA and compliance issues. The app securely integrates with the Forcura Workflow product enabling complete document and patient management. The integration with Forcura’s newest version of Forcura Workflow provides a seamless way to send, track, and receive all patient documents.

“The Forcura products, Workflow and now Messenger, are making it possible for my staff to work at maximum capacity at a manageable pace,” said Kim Gaffey, CEO of Gaffey Home Hospice & Nursing. “And I’m breathing freer to know that they are always working in a manner that is not only efficient, but legally and ethically compliant.”

About Forcura
Forcura, is headquartered in Jacksonville, Florida. The Forcura platform consists of two primary products: Forcura Workflow, paperless document management, and Forcura Messenger, secure healthcare messaging. The company recently received awards for Best Use of Cloud Computing, Best CEO and Best Places to Work.



by Roger McManus, MBA (who has held several positions as Director of Strategic Relationships).

US businesses spend $360 million on advertising every day. And, every day, 80 percent of people who are not familiar with an advertised business will check it out online before spending a dime. [McManus describes significant changes in businesses’ advertising practices, with particular note on how these changes can affect advertising by today’s  healthcare at home agencies. Directives on how to spend advertising dollars wisely today are provided. Details about the importance of using “reputational marketing” are discussed.]


Certainly, it used to be different, and not that long ago. Put a clever ad on the radio or television and people would call on a (landline) telephone or drop by to at least give a business a try.

Not anymore!
Companies that provide healthcare services at home have always had to carefully spend advertising dollars but the definition of “carefully” has changed. To put it another way, the objective is still to get new clients but the tactic is now to move people to go to their computers and smart phones, not to knock on your door.

This is the best you can hope for today. They are not going to call you first. Calling you will be their third move, if they call at all, which depends heavily on what they find through Google star ratings and Yelp reviews and other online rating systems. After they see what other people — yes, perfect strangers — have said about you, they may then go to your web site. If they like what they see there, they may call.

Good, bad, or indifferent, this is the way people shop today. At its best, advertising only gets people to go online, where they will believe the opinions of people they do not know before they decide to spend money with a business.

In this new world, today’s reasoning goes, you spend your attention and your resources in this order:

  1. Deliver a top quality product
  2. Capture the reactions of customers who are pleased with the effort.
  3. Invest in traditional advertising.

To promote your business in any other sequence would simply be a waste of advertising dollars, even if the obsolete methods worked as recently as two years ago.

Reputation Marketing

Reputation Marketing has the effect of “insuring” advertising dollars. When your ads evoke a response, 80% of people first go to online reviews. If what they find there is a realistic, generally positive, view of your business, your advertising investment has paid off. If it is mostly negative, your budget has been wasted.

This is what people are calling “Reputation Marketing.” It has nothing to do with covering up negative reviews. (See “Why Yelp Doesn’t Lose in Court” in last week’s issue about the futility of trying to delete negative online comments.) It has everything to do with multiplying the number of positive reviews by identifying happy customers and getting them to repeat their positive comments online.

The unfortunate fact is that happy customers expect to be happy. Good service is, perhaps, appreciated but not so exceptional that it inspires people to rush home and comment about it online. A bad experience, however, is entirely different. It is always exceptional. People will go to the extra effort to warn others — yes, perfect strangers — by vilifying a business that has not served them well.

Logic would suggest that a business that has survived for a while must be pleasing more customers than it displeases. This does not matter if those happy customers are less vocal than the few unhappy ones. The whole system of online reviews skews toward a negative bias. It is simply human nature to use the anonymity of online review tools to criticize rather than praise.

In with the good, out with the bad
Lastly, Reputation Marketing is a two-pronged tool. Savvy businesses use it to promote positive reviews and to find, and dialog with, the writers of negative reviews. Preventing a small situation from becoming a big broadcast is another form of “insurance,” protecting future advertising spending. Making it easy for happy customers to express their experience with you in a public forum turns the insurance into an annuity.

Roger McManus is an online marketing consultant. He teaches businesses how to automate the solicitation of online reviews. He can be reached at rogermcmanus.com/reviewsoftware This article was originally published on 8/5/15.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com


 by Audrey Kinsella, MA, MS

They call it the Virtual Exam Room. Oakland, California-based Dictum Health has released a telehealth service designed to replicate a physician office visit, electronically capturing and analyzing patient conditions via laptops and tablets. This new player in the remote patient monitoring game also has offices in Portsmouth, New Hampshire and Dubai, UAE.

 Still another telehealth packaged program? Yes, but this one may be a little different in that it gives people direct access to their physician, particularly helpful to supporting self-management routines for healthcare at home patients living with multiple chronic conditions who may find it difficult to travel to a doctor’s office.
Closing the gap
Dictum Health says that its Virtual Exam Room replicates a clinical examination room, private and up close, using the same medical equipment used in on-site care. Virtual visits are facilitated by a light-weight, FDA-cleared, IDM100 videoconferencing system which provides real-time data streaming through Dictum Health’s Care Central software. Data are transmitted between laptops or tablets through a cloud-based, cyber-secure, HIPAA-compliant system. [Kinsella provides more details about the system’s features and design for use by all manner of patients, particularly seniors living with multiple chronic diseases. The key advantage for such patients being able to connect as-needed with their physicians is discussed.]
Figure 1

According to VP Deb Anderson, patients’ report that they do not perceive the system as mechanical and impersonal and are not put off when working with it. She attributes this to the system’s intuitive, straightforward iconography. [see figure 1]

When describing the advantages of the VER, Anderson talks about more than just not being in the hospital but regaining the ability to go about normal daily activities at home, beyond those activities related to chronic disease management.

Managing bad days
Often, living with one or more chronic conditions means having a good day once in a while, sometimes just having a few good hours. Clinicians know that not-so-good days cannot be predicted for people living with such conditions as lupus or fibromyalgia or even multiple sclerosis. A person may want to contact his or her physician  when an appointment — virtual or in-person — is not scheduled.

The VER was created to accommodate people on these bad days in a way that traditional vital sign monitors cannot. When a patient enters the virtual exam room, the physician can view current readings, patterns over time and anomalies,  and address them in real time.

Longtime readers know of my previously expressed concerns about the usability of in-home technologies. Granted, there are always examples of tech-savvy seniors who take to healthcare devices, and many other gadgets for that matter, with ease. For many seniors, however, even the most intuitive technologies are challenging. Dictum Health began with the premise that their system had to be usable by the latter group.

Figure 2

According to Ms. Anderson, preliminary testing indicated that training on the Virtual Exam Room is virtually unnecessary. She noted that test groups ranging from teenagers to elders in every life experience category to seasoned technology professionals learned the system with minimal training. “The system is quite intuitive,” she said. “Large, iconographic buttons for all functions are very clear.” [see figure 2]

Who knows? A system that helps seniors living with multiple chronic conditions “push all the right buttons” may well also help them stay well and live independently longer.

Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

By Tim Rowan, Editor & Publisher, Home Care Technology Report

One of our advertisers, an EMR vendor, reported to us this week that they have been getting requests to add a feature to automate the process of submitting OASIS documents to CMS via the ASAP system (National OASIS Assessment Submission and Processing). The argument is that such a feature would simplify the procedure and save the Medicare home care provider precious time that they now spend logging onto ASAP, locating the file on their server, and submitting it. [Tim Rowan discusses the specific, warning  response (received directly from CMS) to this addition to one’s ASAP system.]


The requester used leverage. “One of your competitors has been soliciting our business and they offer automated OASIS submissions. If you added that feature for us, we wouldn’t have to consider switching to them.”

We helped our advertiser research the question and learned that they received the following missive from CMS, in an email signed not by a person but by “The OASIS Tech Issues Team.”

Thank you for your inquiry. CMS does not allow automated scripting to be used for submissions of OASIS data to the ASAP system, as it is against CMS security policies. You are correct that there are vendors who submit for providers. However, if it should be discovered by CMS that a vendor is using automated scripting to submit, their scripting software’s access to the ASAP system will be discontinued.

What is the phrase? “Let the buyer beware.” If your EMR software vendor offers this “convenience,” apparently you had better make them stop before you both get in trouble.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com


by Roger McManus, MBA (who has held several positions as Director of Strategic Relationships). Fouth in a 5-part series. 

Part 4  in a 5-part series.

While it is a bad idea to try to slip a hard sell into your social content, make no mistake, Facebook is all about selling. The good news is that Facebook advertising is not like any medium that has ever existed in the history of marketing. Never before could you define almost exactly to whom you want to send a message and target that precise audience.

Think of it like a television program where your programming is customized for different subsets of your audience which will react most like you want them to. The program is not even delivered to people who are less likely to be interested – and you only pay for those to whom you really want to reach.

To further that analogy, you know that you will occasionally see product placements in the content part of a television program, which becomes clear when there is a commercial break. Both are acceptable to the audience because everyone understands the rules but a television program that comes off as an infomercial generates a much more cynical response. To make such vehicles acceptable, they are clearly labeled as paid advertising. The audience will accept it if you do not insult their intelligence.

So how do you get a “product placement” in Facebook? The term Facebook uses is “Boosted Post.” If you find that a post you have written is performing particularly well, you can purchase a boosted post and get Facebook to push it a bit further to a broader audience of people who match the demographics of your current participants. It appears higher up in their news feeds. It is a much cheaper form of advertising but, like product placement, more subtle.  The cost depends on how many people you want the post to reach.

When you want to run a commercial, Facebook does a great job of that, too but your audience knows it is a commercial and accepts it as such. Combined with the social impression you have made already, they are far more likely to react to your paid commercial more favorably. With digital advertising, you can reach people you care about at the exact moment they are ready to listen. It all works together.

You no longer have to rely on the right people driving by your billboard, seeing your 30-second TV spot or subscribing to the magazine with your local ads tucked away in the pages. Perhaps most importantly, you do not have to worry about as many disinterested people seeing your ads.

How it works
Facebook allows you to set a budget and they will tightly control your exposure to match that budget. The objective of a Facebook ad is to make it possible for you to run ads depending on who your target is and what interests him or her about you. It is a great opportunity for you to reach people you know are interested in your business. Facebook assumes, however, that other businesses may be interested in the same targets. To avoid cluttering Facebook with too much advertising, exposures are tightly controlled to limit the number of ads any individual might see in a given session.

Essentially, you write your copy, establish your budget and determine how long you want the ad to run. Facebook will then optimize the placement of your advertising to make it seen by those most likely to take action. The ad runs until your budget goes to zero or the time limit for your ad is reached. Either of these factors are completely adjustable by you. If your ad is doing well you may expand your budget or extend your time. If it is not doing what you expect you can put the ad on pause to adjust your copy.

New Service Coming
In the interest of full disclosure, this would be a good time to tell you that the content service Roger is describing is one of the new offerings from Rowan Consulting Services, the publisher of Home Care Technology Report. Learn the details at  RowanReputationResources.com.

Facebook determines who sees your ad through a complex algorithm that takes into account the information a Facebook member shares including the pages he or she “likes.” Other information they use comes from the participant’s Facebook account (e.g. age, gender, location) plus the online activity on websites and apps outside of Facebook.

Precisely how to create, place and budget a Facebook ad campaign is beyond the scope of this article. Suffice it to say, that digital advertising is a dramatic shift in advertising strategy and, for those who learn it early, will provide a significant advantage over local competitors who have not picked up on it yet.

It is best, of course, to place advertising within the context of your position as a member of the interested community. This means non-sales messages preceding an advertising blitz. To accomplish this, you need only to produce posts that play to the interests of an audience that likely has older parents approaching the time when they may need in-home help. You can write these yourself, re-post items written by others on Facebook or subscribe to a program that produces and personalizes home care specific content on a daily basis.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com




Compiled by Tim Rowan, Editor & Publisher of Home Care Technology Report

 Three  vendors are highlighted this week: KanTime Healthcare Software (San Jose, CA) ; and a partnership between AMD Health Partners  and Revolve Robotics. KanTime announced a  debut of its  offline hospice app. and the a partnership between AMD Health Partners (New York, NY) and Revolve Robotics (San Francisco, CA) is expected to help patients living with chronic conditions to better manage their health using the telepresence  of a robot to which is programmed help patients living with chronic conditions to better manage their health, strengthen their connections with their care teams and reduce unnecessary ED visits and hospitalizations.


Pre-release trials show promise for “RiskPoint,” new hospitalization management solution

Austin, TX – May 10, 2016 – This week, Kinnser Software launched Kinnser RiskPoint, a predictive analytics software solution to help home health agencies reduce hospitalizations, and presented strong results from agencies that have been using the solution in a pre-release trial since January.

The new analysis tool utilizes a predictive algorithm based on real-world data from Kinnser’s customer base, which the company describes as the largest dataset in home health at more than 3 million patient episodes. Every day, Kinnser RiskPoint automatically analyzes hundreds of data points in the medical record of each patient of a home health agency, looking for indicators of hospitalization risk. A dashboard displays results for clinical staff so they can drill down to details and devise a preventative action plan with the patient’s clinical team.[Details in this news release touch on Kinnser RiskPoint as a predictive analytics software solution for healthcare at home agencies’ achieving reduced and preventable hospitalizations. Comments from users in pre-lease trials of RiskPoint are included at the end of this article.]


Tackling a multi-billion dollar problem
In its May 10 news release, Kinnser cited figures from the Medicare Payment Advisory Commission estimating that 76% of hospitalizations are preventable. With 15.3% (1,025,000) of the 6.7 million home health patient episodes that occurred in 2015 ending in a hospital admission, and at an average cost of $11,200 per admission, this amounts to over $11 billion in total healthcare system costs. This is the reason Kinnser developed RiskPoint, to tackle the problem of preventable hospitalizations.

“Preventable hospital admissions represent a significant opportunity for home health care and for our country,” said Chris Hester, president and founder of Kinnser Software. “Kinnser RiskPoint puts the tremendous power of data science and machine-learning technology into the hands of all home health providers. And the results thus far have been truly amazing. With this solution as their competitive advantage, our agencies will be able grow their businesses while also improving the lives of their patients.”

How it works: predicting the future by using the past
For over a year, Kinnser’s team of data scientists analyzed over 2,100 data points for more than 3 million past patients Kinnser customers have logged into its web-based EMR application. After gaining a better understanding of the most powerful underlying predictors of hospital admissions, the team developed an algorithm strengthened by information from each patient’s comprehensive assessment and plan of care and updated daily with new vital sign information. It is this deep, real-time data set that adds accuracy to the system’s predictions. Released on Tuesday, Kinnser RiskPoint is available now to home health agencies using Kinnser Agency Manager.

About Kinnser Software
Kinnser Software, Inc. provides web-based software for the home health, hospice and private duty industries. Founded in 2003 and headquartered in Austin, Texas, Kinnser Software serves more than 4,000 home health, therapy, hospice, and private duty home care providers nationwide with software supporting scheduling, billing, electronic visit verification, day-to-day operations, and patient referrals.

About those early results

Community Home Health, Inc. serves an average of 380 patients in Claremore, Oklahoma. “We saw a large hospitalization reduction,” said COO Jonathan Wohlgemuth. “Comparing February 1 to March 31 of 2016 to the same period in 2015, we reduced our hospitalization rate from 11.6% to 8.2%. That’s a 29.7% reduction.”

Gayla Anderson, RN, BSN, MHR Community Home Health’s Director of Nursing believes the new software is helping her patients receive better care. “Kinnser RiskPoint helps you be a better nurse,” says Anderson. “It prompts you to dig deeper, look harder, and listen more closely…not just to keep patients out of the hospital, but to ensure they have better outcomes.”

User discovers marketing value
Another early RiskPoint user, Custom Home Health in Royal Oak, Michigan, serves an average of more than 300 patients. Agency president Chris Tillotson sees a marketing value in Kinnser RiskPoint, as evidence by his agency earning new business with an ACO. “Every ACO in the country cares about hospitalization,” says Tillotson. “Kinnser RiskPoint is absolutely a differentiator––a golden nugget in our pocket. It’s a tool that Custom Home Health will use with every referral source.”

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com



by Tim Rowan, Editor

By now, you have probably heard about the May 3 report in The Washington Post, repeated on NPR and network TV news broadcasts, citing research that shows medical errors to be the third leading cause of death in the United States. I hope you appreciate what an opportunity for healthcare at home providers.

The research the Post reports reveals that people are being injured and dying from the care provided to them more than they are dying from their diseases. At 271,000 deaths per year, medical errors claim nearly 700 lives per day. A typical Boeing 747 carries 416 passengers. Imagine what would happen to the airline industry if two full-loaded jumbo jets crashed every three days. How do hospitals escape the same consequences? [Rowan provides details that healthcare at home providers need to use, based on these medical error findings, to leverage the comparative safety of healthcare at home provision.]


According to lead researcher Martin Makary, professor of surgery at the Johns Hopkins University School of Medicine, hospitals settle medical error wrongful death cases only with gag orders. “No one involved may ever speak of the hospital’s admission of guilt for the rest of their lives,” he told NPR. “Airlines don’t have that option.”

Nobody does it better
Healthcare payers and patients are the stake holders most impacted by this problem. Providers of in-home healthcare services should be printing this Washington Post article and giving copies to every sales person. They should be posting the link to it on their own web sites. They should bring it to every managed care contract negotiation.

Our healthcare sector has been trying to convince payers and regulators for years that not only is care in the home the alternative preferred by people but that it is also the most cost-effective alternative to in-patient and long term care. Now we have another reason to urge payers and discharge planners to get people out of the hospital and back home under our care as quickly as possible. We don’t kill people.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com


By Tim Rowen, Editor & Publisher, Home Care Technology Report

The Mature Market Resource Center’sSM sixth annual New Product & Technology Awards® competition will accept entries beginning Monday, May 9. Complete details about the awards and a PDF copy of the 2016 Call for Entries brochure can be found at agingawards.com.

The awards program, the first of its kind, recognizes the world’s best technologies, products, and services for older adults and their families. The 2016 entry deadline is June 30, and the entry fees are $59 or $79 per submission, based on the entry category.

Gold, Silver, Bronze, and Merit recognition will be presented in 58 entry categories and 15 entry divisions. A complete list of 2016 entry categories and divisions, along with FAQs and all entry information can also be found at agingawards.com. [Details about the lauded aims of the winners of these awards and their products for assisting seniors to age in place are noted, and a list of previous winners of recent new product and technology awards is provided.   Information about sponsors of this competition is noted, as are many details about becoming a sponsor of The Mature Market Resource Center’sSM sixth annual New Product & Technology Awards® competition.]


“We have added new categories recently to reflect the explosive growth of technology applications for seniors,” explained Chris Behrend, director of the awards program. “For example, many older adults would prefer to remain in their homes as long as possible, and winners in the competition are helping to make this wish a reality.”

Recent New Product & Technology Awards winners include:

  • Area Agencies on Aging
  • American Specialty Health
  • Blue Cross Blue Shield Plans
  • Cardiocom
  • Cognifit
  • Dakim
  • e-Care Diary
  • GeriJoy
  • GlynnDevins
  • The Hartford
  • Home Instead Senior Care
  • Lively, Inc.
  • Medicare Health Plans
  • National Institute on Aging
  • NavGate Technologies
  • Sit and Be Fit
  • Retirement Communities

GeriJoy, a Care.Coach Service, was also the recipient of the 2015 “Nana” Award for best in competition among the entries for new technologies. The “Nana” Award is a special recognition introduced by Andrew Carle, Founding Director and Executive-in-Residence for the Program in Senior Housing Administration at George Mason University, Fairfax, Virginia.

2016 sponsors will be announced later this month. Sponsors for the 2015 awards included:

  • Aging 2.0
  • ProMatura
  • George Mason University’s Program in Senior Housing Administration
  • American Custom Publishing

Mature Market Resource CenterSM, (MMRC), organizer of the New Product & Technology Awards, is a national clearinghouse for professionals who work in senior markets. In addition to the New Product & Technology Awards, the MMRC organizes the National Mature Media AwardsSM, the nation’s largest program of its kind (seniorawards.com), National Senior Health & Fitness Day® the nation’s largest older adult health and wellness event (fitnessday.com), and the Mature Fitness AwardsSM, the first national fitness recognition program for older adults (fitnessday.com/mfa).

MMRC is also seeking sponsors for this year’s event. Details below.

A limited number of national sponsorship opportunities are available on a product/category-exclusive basis for organizations interested in reaching executives and professionals working in senior market fields.

Sponsorship Benefits Include:

  • Awards program sponsorship brand or product-category exclusivity for your company (based on availability), with the right of first refusal to renew your category-exclusivity for the 2017 awards.
  • Sponsorship of both the 2016 New Product & Technology Awards®, and the 2017 National Mature Media Awardssm.
  • Access to the awards program database for your marketing and promotional purposes.
  • Choice of exclusive recognition by your organization in one award category.
  • Title sponsorship of the inaugural New Product & Technology Awards Senior Showcase, the first-ever consumer exhibition of entries submitted for the 2016 competition. This display will give older adults and their families the opportunity to review and comment on the latest products, services, and technologies from organizations that have entered the 2016 competition. The first “Senior Showcase” will be held in the Chicago area this summer.
  • Up to 5 free entries for the 2016 awards program (a $300+ value). Use these free award entry certificates for your own submissions, or share them with clients and colleagues.
  • Strategic sponsor ad placement on both the awards program website: seniorawards.com and the awards program newsletter, Senior Awards News, which is sent regularly to thousands of the program entrants and prospects.
  • Recognition of your sponsorship and contact information on all awards program certificates and online/ print materials; links on all program websites; “About Our Sponsor” editorial profiles in issues of Senior Awards News; and sponsor recognition in all national media materials.
  • Recognition of your sponsorship on Twitter during the live awards announcements (4-6 sessions, spread over 2-3 days). Mentions can include Twitter handle and/or hashtag.
  • Option to include a one-page promotional flyer with the certificates and materials sent to all New Product & Technology Awards® competition winners.
  • Option for ad recognition in the inaugural issue of the Robotics & Seniors e-newsletter, a new MM RC publication tracking developments in this fast-growing field.
  • For more information and sponsor fees, contact Gary Ford, Mature Market Resource Center: gford@seniorawards.com, 1-800-828-8225, agingawards.com/sponsors

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com


by Sokolove Law [a personal injury law firm (Chestnut Hill, MA)

Moving a loved one into a nursing home is one of the most difficult decisions for a family to make. This choice can be even more stressful when families have to worry about inadequate care or nursing home abuse. Unfortunately, these problems are all too common. In fact, a 2000 study by the U.S. House of Representatives found that elderly abuse occurred at 1 in 3 nursing homes. According to the 2014 Nursing Home Report Card, nearly 90 percent of all nursing homes were cited for violating state or federal laws. [The authors provide 5 “common traits shared by the worst nursing homes in America,” in this article, along with details on identifying characteristics of elder abuse.]


When assisted living facilities and nursing home owners put profits ahead of people, the consequences can be serious or even fatal. Knowing the signs of nursing home abuse and neglect can help prevent these tragedies and protect your aging loved one. So, what should you look out for? Here are 5 common traits shared by the worst nursing homes in America.

1.) Physical and behavioral signs of abuse or neglect.
Do residents show signs of frequent and unexplainable injuries such as broken bones, burns, cuts, or bruises? Is clothing or bedding often bloody or stained? Although obvious evidence of physical abuse is very rare, the evidence of neglect is more rampant. This type of evidence includes bedsores, complaints of blisters or aberrations, poor hygiene, weakness, inexplicable weight loss, constant thirst or dry skin (from dehydration), soiled bedding, rooms that are too hot or too cold, and sporadic or excessive medication. Furthermore, if a resident has sudden personality changes, exhibits clinginess or a fear of being left alone, or is often withdrawn and depressed, neglect and/or abuse may be occurring at his or her facility.

2.) Insufficient staffing and high staff turnover.
Although many families look at the lobby or cafeteria when choosing a nursing home, the biggest factor for determining quality of care is often the staffing levels. The best nursing homes have the best staff to resident ratios. Substandard nursing homes will try to cut costs by hiring fewer employees and nurses than they really need. This means that residents receive inadequate attention and human interaction. Furthermore, nursing homes with a high staff turnover rate fail to create an environment where residents and staff get to build relationships.

3.) The residents lack independence.
The well-being of residents increases if they are able to make their own decisions and have greater freedom. For example, if residents are able to decorate their rooms as they wish, they will be happier. Conversely, if residents are subject to strict rules and overbearing supervision, such as an enforced curfew, they will be less happy.

4.) A history of violations.
Frequently being cited for deficiencies indicates that the ownership of a nursing home is probably more interested in making money than in providing the best care and lifestyle possible for residents. Nowadays it’s relatively easy to find out which nursing homes have a history of violations. Medicare.gov offers a website where people can view the ratings of different nursing homes. The ratings are based on factors such as staffing and inspections, and full reports regarding each nursing home are available. US News’s Best Nursing Homes 2014 offers a similar search engine, as does The National Long-Term Care Ombudsman Resource Center. The Centers for Medicare & Medicaid Services (CMS) manages a Special Focus Facility list which names the worst nursing homes in the country. While looking at the history of a nursing home, however, it is important to keep in mind the severity of each infraction. For example, if a nursing home has only been cited once, but the violation was very severe, then that nursing home may be less desirable than one with many less-serious violations.

5.) For-profit nursing homes.
For-profit nursing homes are consistently proven to be worse than not-for-profit facilities. In 2009, a Government Accountability Office study found that about 55 percent of poorly performing nursing homes were for-profit and chain affiliated. Another study carried out by Physicians for a National Health Program concluded that not-for-profit nursing homes had better staffing. The same study found that bedsores were more prevalent at for-profit facilities. When nursing home ownership is concerned principally with making money, they cut corners to the detriment of residents and their loved ones. Unfortunately, the results can be heartbreaking.

Sokolove Law is a national personal injury firm that refers cases to local partners.