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The many extracts on this page are from copyright material. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that all of the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of the allegations made.


Care AFTER the Mariner mergers


This page examines care following the acquisition of Living Centers of America by Grancare to form Paragon - the acquisition of Prism and Amerra Health Network by Mariner Health Group - and the absorption of Mariner Health Group into Paragon under the name Mariner Post-Acute Network in July 1998. The new company soon released a press report describing its plans to improve care and indicating how it planned to do this.

The industrialised model of care which it proposed was factory based and not congruent with the needs of patients. Its intentions were irrelevant because the marketplace soon put an end to them. As a consequence there is little evidence that Mariner did anything about the poor care in its homes. They continued to be cited for deficiencies and poor staffing - if anything the problems got worse.

The extracts on this page describe care after the Grancare to Mariner mergers.


COMMENT:- It is clear from the following two reports that Mariners ambitions to provide care were hollow indeed. Wall street has dictated that costs be cut and Mariner has incentivised cash flow. It is not surprising that the understaffing and poor care, which characterised Grancare persists.

Inspectors fine Bayside nursing home U.S. agency threatens to halt Medicaid and Medicare income
Milwaukee Journal Sentinel March 19, 1999

A Bayside nursing home has been fined more than $20,000 and is being threatened with termination from the federal Medicare and Medicaid programs as the result of state surveys that found helpless patients without blankets and resident rooms and dining areas with filthy floors, walls and furniture.

Audubon Health Care Center, 601 W. Glencoe Place, is being fined $250 per day retroactive to a Dec. 17 state survey, which found substandard conditions. In addition, the federal Health Care Financing Administration has denied the home payment for any new admissions under the Medicaid or Medicare program as of Feb. 13.
Records show that state inspectors visited the home Oct. 26, after receiving a complaint. At that time the home was cited for filthy dining areas.

By the time of the annual recertification survey Dec. 17, conditions had deteriorated and the home was cited for 26 federal violations, including substandard care, and seven state violations. On one unit, 36 patients who were unable to as k for help were without a blanket, the records said. Inspectors also noted that many of the wash cloths, towels, sheets and pillow cases were worn thin and had a yellowed, stained appearance.

Substandard care was cited because the home di d not "provide a safe, clean, comfortable and homelike environment in four of five floors."

"The dining room floor was very dirty with dried urine spills and trash," inspectors wrote. "The chairs in the dayroom were dirty. Next to the day room was the family room which smelled of urine all days of the annual survey. In the corner was a desk that was dirty. The wallpaper was peeling, and the walls were in need of painting."

Inspectors cite nursing home for poor care State says insufficient staffing meant residents were dirty, meals delayed
Milwaukee Journal Sentinel March 20, 1999

A Brookfield nursing home has been cited for 21 federal violations, including inadequate staffing, after state inspectors found residents with dirty hair and clothing and others calling out for food after waiting a half-hour or more for t heir meals.

Woodland Healthcare Center, 18740 W. Blue Mound Road, was also cited for two state Class B violations, which is one step down from the highest level. The home is licensed for 226 beds and has about 218 residents 172 paid for by Medicare or Medicaid and 46 private pay.

The home is owned by Mariner Post-Acute Network in Atlanta, a company formed last year through the merger of three health care providers. Mariner owns Woodland and 10 other nursing homes in the Mi lwaukee area.

The state Bureau of Quality Assurance has recommended to the federal Health Care Financing Administration that the home be fined $300 a day retroactive to March 10 until the facility is found to be in "substantial compliance ." If the nursing home is not in compliance by April 20 the state is recommending that the facility be denied Medicare and Medicaid payments for new admissions.

Among the areas cited by surveyors were:

Inadequate staffing on three of six units inspected, which resulted in residents waiting for food, toileting, grooming and repositioning. One surveyor watched for 10 minutes while a resident who needed help with meals ate applesauce with her fingers. During that time the " call telephone" at the nurses' station continued to ring with no staff available to answer it. On one unit inspectors found four nurse aides assigned on the day shift to help 61 residents.
Residents told state inspectors they often had to wait to eat meals. On one day a surveyor saw 42 residents seated in the dining room without food, 25 mi nutes after supper was to be served. Two days later an inspector saw 38 residents sitting in the dining area without breakfast trays, half an hour after their meal was to be served. About 25 minutes later 10 residents were still without trays. "Pleas e let us eat, please let us eat," one frustrated resident called out.

Housekeeping. Inspectors found more than a dozen dirty resident wheelchairs.

The facility did not ensure that each resident received adequate supervision to prevent accidents in 6 of 37 cases surveyed.

In two cases, the facility did not notify the physician and/or the family when there had been an accident or significant change in the resident's condition.

In one case surveyors faulted the facility for calling only one of two emergency contacts listed. That oversight resulted in the man being without his family "at his time of death," the report says.

Last April, the home was cited and subsequently fined $10,000 f or a Class A state violation for failing to notify a resident's doctor of a change in condition which resulted in the resident "becoming profoundly dehydrated . . . which created the substantial probability for resident death." The resident was lat er hospitalized and died.

Kym Spell, a Mariner spokesperson, said the home disagreed with the citation issued in April and was appealing that fine.

Nursing homes in staff crunch; Worker shortage called threat to patient care
Milwaukee Journal Sentinel March 21, 1999

Short-staffing citations against nursing homes from Milwaukee to Marshfield have tripled in two years, and the problems have led to harmed residents, burnout among front-line aides and licensed nurses, and widespread use of temporary workers, the Journal Sentinel found. Some understaffed homes are rejecting patients.
The staffing squeeze, fueled by high turnov er, is more pronounced at for-profit nursing homes and in the Milwaukee metro area compared with outstate, state figures show.
Corporate-owned homes accounted for 30 of 35 facilities cited for violating federal nurse staffing standards since 1997, with non-profit homes making up the rest, state records show .
At times, nurse aides at River Hills were assigned 17 residents, most needing total care, records show. Meals and toileting were delayed.

River Hills West was acquired in 1998 by Atlanta-based Mariner Post-Acute Network, which now owns four homes in Wisconsin cited for short staffing in the last year.

In an interview during a tour of the bright and clean Pewaukee home, administrator Richard Hollander said turnover was down, employee morale was up and a recent state inspection documented the home's comeback from a rough 1998. After being cited for short staffing, the home attacked its worker shortage with bonuses for all new and current employees, an hourly starting wage of $8.50 for aides, and van service for Milwaukee workers.
The Journal Sentinel reported Saturday that another Mariner home, Woodland Healthcare Center in Brookfi eld, had been cited this month for short staffing.

Last October at Mariner's Sunny Hill Health Care Center in Madison, inspectors found a pattern of patient harm because of low staffing. Aides couldn't change incontinent residents, turn p atients or adequately feed them. At Park Manor Healthcare Center in Milwaukee, another Mariner facility, a woman's fall down a ramp was attributed to short staffing.

Mariner executives would not talk to a reporter. A regional executive issued a statement saying its employees were dedicated to caregiving despite the constraints of Medicaid reimbursement rates that can be less than a stay in a Madison hotel room.

Modern Healthcare April 12, 1999

Surveys of allied health personnel shortages in the 1990s often put physical therapists at the top of the list. But the changing finances of post-acute-care companies have turned rehabilitation therapy from a hot profession into a dud.
The changes, which limit the amount of therapy and the rate of reimbursement, have prompted many nursing homes to provide less therapy to their patients. And a proposed prospective payment system for rehabilitation hospitals could tighten the screws further
Other long-term-care companies that have laid off up to 20% of their therapists include Atlanta-based Mariner Post-Acute Network, which cut 1,200 therapists; Fort Smith, Ark.-based Beverly Enterprises and Owings Mills, Md.-based Integrated Health Services, which eliminated 1,000 therapists each; and Kennett Square, Pa.-based Genesis Health Ventures, which cut 321 positions.

Health agency to add nursing home inspectors; Audit found state slow to respond to complaints
THE BALTIMORE SUN April 16, 1999

State health officials are about to substantially increase their nursing home inspection staff after a federal audit report strongly criticized Maryland for long delays in responding to complaints of poor care from patients, their families and health care workers.

State inspectors have taken action against another nursing home. Benner (from the state Department of Health and Mental Hygiene) said that serious deficiencies were found at Mariner Health of Catonsville, in the first block of Smith Ave. She said the home was one of three Mariner Health facilities in the Baltimore area cited recently.

She said state and federal officials have notified the operators of the 143-bed Catonsville facility that payments for new Medicare or Medicaid patients will be cut off as of April 30 unless the deficiencies are corrected. Funding for current patients will be cut off by the end of May.

Officials at the nursing home did not respond to a request for comment.

Benner said the notice was the result of a series of inspections, the most recent of which found serious problems with care provided to two elderly patients. In both cases, Benner said, nursing home personnel had failed to recognize and treat such serious health conditions as severe anemia.

She said the nursing home also failed to comply with the request of a patient that she not be resuscitated in the event of cardiac arrest. Despite the request, the nursing home called 911 when the patient was nonresponsive.

"That," said Benner, "is a serious problem."

She said the state also had recommended to the U.S. Health Care Financing Agency that the owners be fined $1,200 a day. She said the findings indicated a pattern of care that could result in harm to patients.

Catonsville nursing home decertified, remains open; Facility to lose funding for subsidized residents

State and federal officials revoked the Medicare and Medicaid certification of a Catonsville nursing home yesterday after it failed to correct a series of problems relating to the care of some residents.

Karen Black, a spokeswoman for the state Department of Health and Mental Hygiene, said that despite the decertification, Mariner Health of Catonsville will not be forced to close and the 120 patients will not be transferred.

Under an agreement reached with the state late Thursday, Mariner, an Atlanta-based health care chain, will hire a state-approved consultant to help correct the problems uncovered by state inspectors in a series of recent surveys.

COMMENT:- What will happen to the patients previously served by all these therapists?

Atlanta nursing home chain to cut 7,300 jobs
The Atlanta Journal and Constitution May 18, 1999

Atlanta-based Mariner Post-Acute Network, citing deep Medicare reimbursement cuts, announced Monday that it was laying off about 7,300 employees --- nearly 300 in Georgia --- because it is closing its rehabilitation business and restructuring.

Woman charged with disorderly conduct after nursing home incidents She is accused of interfering with staff members who were caring for her mother
Milwaukee Journal Sentinel June 2, 1999

A New Berlin woman recently sued by the city for allegedly harboring a vicious dog was charged Tuesday with disorderly conduct in connection with several disturbances at a Brookfield nursing home.

Betty J. Demshar, 62, insisted in court Tuesday that she was merely trying to protect her 98-year-old mother, who she alleged was being mistreated at Woodland Health Center, 18740 W. Blue Mound Road.

"Those people are not treating her right," said Demshar, who said she wanted to remove her mother from the nursing home.
Woodland Health Center was sued in March in connection with the death of an 86-year-old resident who allegedly was burned by hot coffee and received negligent care. Also, Woodland was recently cited for 21 federal violations after inspectors allegedly found residents with dirty hair and clothing and others calling out for food after waiting for meals.

COMMENT:- The next report is mainly about Manor Care but Mariners similar problems are reported

Wisconsin State Journal June 11, 1999

Sunny Hill Health Care Center, 4325 Nakoma Road, is also working toward fixing a smaller number of violations from a state visit this year, said Tschumper.

She said a number of problems at Sunny Hill had been identified in a lengthy report last year, and those problems had been fixed. A much smaller number of violations were found in a recent state visit, she said.
Sunny Hill is owned by Mariner Post Acute Network in Atlanta.

Catonsville Home Shows Potential for Peril
The Washington Post June 19, 1999

If the records of a Mariner nursing home in Catonsville, Md., told an accurate story, the treatment of a 73-year-old woman connected to a feeding tube on Jan. 9 would have been a model of conscientious care.

The nursing staff administered seven medications at 9 a.m., and another five medications at 5 p.m., the records showed. The staff noted that the patient's feeding tube was checked four times, her feeding pump was run continuously during the day and evening shifts, and she was given 'water flushes' to clear the feeding tube every four hours.

But the home wasn't as thorough as it seemed.

Before any of that care was supposedly provided, inspectors found, the patient "had expired and her body had been removed from the facility."

Citing persistent deficiencies in patient care, regulators recently dropped the Mariner Health of Catonsville nursing home from Medicare and Medicaid, the government insurance programs for the elderly, poor and disabled.
Either way, Mariner Health of Catonsville provides a warning of what can go wrong in facilities entrusted with the care of sick, elderly, vulnerable people -- and the warning has taken on new urgency, because much of the nation's nursing home business is in financial distress.

Mariner Post-Acute Network Inc., the corporate parent of the Catonsville home - - - lost $ 117.8 million on revenue of $ 1.3 billion during the six-month period that ended March 31, and its stock closed at 62 1/2 cents yesterday, down from a 52-week high of $ 17.12 1/2 last July. - - - - - , may not have enough money "to sustain operations" and pay its debts as they come due, the company said in its latest quarterly report to the Securities and Exchange Commission. Last week, the company's chief executive resigned.
The nursing home was threatened with disqualification from Medicare and Medicaid in November but failed follow-up inspections in January and April, prompting its termination and fines totaling $ 216,000.

State recommends fining nursing home Northwest Health Care issued 16 citations, some linked to suffocation
Milwaukee Journal Sentinel September 24, 1999

A Milwaukee nursing home in which a 74-year-old confused resident suffocated after getting trapped in a side rail while trying to get out of bed has been cited for substandard care and recommended for more than $60,000 in fines.

The state Bureau of Quality Assurance issued 12 federal citations, one state Class A citation and three state Class B citations to Northwest Health Care Center, 7800 W. Fond du Lac Ave.

The recommended fines, which must be approved by the federal Health Care Financing Administration, have reached $61,000 to date and are accruing at the rate of $500 a day until state inspectors find the facility in substantial compliance.
State inspectors reported the male resident who suffocated was found at 5:25 a.m. Aug. 4, with his body over the side of his bed between the side rail and headboard, his legs crossed and caught in the side rail, his forehead and right side of his face on the floor.

The facility failed to report the incident to the state for two weeks, records show.

State regulations require resident deaths to be reported within 24 hours if they are related to the use of physical restraints or a psychotropic medication. Facility administrators told state inspectors they did not consider the side rail, which went only half the length of the bed, to be a restraint.
The nursing home is owned by Mariner Post-Acute Network in Atlanta, a new company formed last year - - -
Among other areas cited by surveyors were:

Failure to inform a resident's physician of a significant change in condition in four of 26 cases reviewed. In one cited case, a diabetic resident's blood sugar declined to dangerously low levels over several days until a doctor was finally called and she was taken by ambulance to a hospital. In another case, the facility did not call a 101-year-old resident's doctor until a day after nurses noticed large amounts of bruising on her arms.

Failure to ensure that each resident maintained acceptable nutritional status. The surveyors found that "meal intake records for each resident for August 1999 were grossly incomplete." Surveyors also reported a review of patient records found 15 residents had experienced an "unplanned weight loss" since admission. One resident lost almost 31 pounds in six months, the report states.

THE ORLANDO SENTINEL October 11, 1999 Monday

Five nursing homes in Central Florida have been placed on a state watch list.

Lakeview Nursing Center Inc. of Sanford, Mariner Health of Melbourne, Oaks of Kissimmee, Plantation Gardens Rehabilitation and Nursing Center of Ocoee and Sunbelt Health Care and Subacute Center of Orlando were named in a quarterly report published by the Florida Agency for Health Care Administration, which oversees the nursing home industry.

The agency cited problems ranging from failure to provide fluids to keep patients hydrated to failure to prevent bed sores.

The list, which was compiled from reports by field inspectors during the second quarter of 1999, identifies another 15 nursing homes in Central Florida that were removed from the list after correcting previously cited problems.

More violations found after death at Bayside care center -- Resident with history of choking was left at lunch unsupervised, state says
Milwaukee Journal Sentinel January 11, 2000, Tuesday Final

A Bayside nursing home owned by a financially troubled national health care provider has been cited for substandard care for the second time in a little more than a year, after a resident with a history of choking was left unsupervised with a tray of food and choked to death.
The nursing home is owned by the financially troubled Mariner Post-Acute Network in Atlanta
Two other Mariner-owned homes have been cited for serious violations by state inspectors in the last year. In September, Northwest HealthCare Center, 7800 W. Fond du Lac Ave., was cited for substandard care after a 74-year-old resident suffocated after getting trapped in a side rail while trying to get out of bed. In March, Woodland Healthcare Center, 18740 W. Blue Mound Road, Brookfield, was cited for 21 federal violations including inadequate staffing, after state inspectors found residents with dirty hair and clothing and others calling out for food after waiting a half-hour or more for their meals.

Spell said problems in these homes were independent of any corporate financial problems and refused to comment on whether the company would file for reorganization under the federal bankruptcy code.
On Jan. 4, Morris was notified by state officials that Wisconsin would be asking the federal Health Care Financing Administration to fine the home almost $90,000 as a result of past and present violations. The home also could face denial of payment for new admissions under the Medicare and Medicaid program if violations remain uncorrected.

Records show that in the last several years, violations have continued to plague the nursing home.

In October 1998, state inspectors visited the home after receiving a complaint and cited the Audubon for filthy dining areas. By the time of the annual recertification survey Dec. 17, 1998, conditions had deteriorated and the home was cited for 26 federal violations and seven state violations. On one unit, 36 patients who were unable to ask for help were without a blanket, the records said.

On a second visit to the facility, in February 1999, state inspectors found a cleaner facility and dropped the substandard rating. Nevertheless, the home was cited for 14 federal violations -- 11 of them repeats from the prior inspection. In April, records show, the home was found to be in substantial compliance on those violations.

In October, Audubon was cited for six federal violations and three state Class B violations during their annual survey.

During the December revisit survey -- which involved an investigation into the choking incident -- the home was again cited for six federal deficiencies -- five of them repeats from the prior inspection. In addition, they were cited for one state Class A violation and one state Class B violation and found to have provided substandard care in the choking incident. Authorities said the substandard rating has since been lifted because Audubon administrators took steps to ensure a similar situation would not recur.

The most recent survey reports state that inspectors also observed a number of residents in urine-soaked or dirty clothing and that the facility did not prevent new pressure sores on three of four residents surveyed.

Problems plague nursing homes Report finds needs are up, staffs are lacking in Maryland
Capital (Annapolis, MD.) January 23, 2000, Sunday

Last month, a state task force on nursing homes issued a dire report on the state of Maryland's nursing home facilities. The task force included nursing home operators, health-care workers, advocates for the elderly and government regulators.
"The quality of care in Maryland nursing homes is in need of immediate government attention," said State Aging Secretary Sue Ward. "A substantial investment of both financial and human resources over the long term will be required to realize changes needed today."
The report found that nursing home residents in Maryland are more disabled and need more assistance than residents in other states. The nursing homes are also larger than the national average and more than half operate for a profit.
The most severe problems received a rating of "actual harm" and included: Failure to give each resident care and services at Mariner Health of North Arundel in Glen Burnie.

Nursing home agrees to shut down
The Associated Press State & Local Wire April 11, 2000

The Atlanta-based operator of a Bayside nursing home has agreed to drop its challenge of a state regulatory action and shut down by late summer, officials said Monday.

State regulators said last month they would remove the license of Mariner Post-Acute Network to run Audubon HealthCare Center as of April 19. Mariner appealed.

As a result of the decision announced Monday, 161 remaining residents will have to move to other facilities.

Firm decides it will close troubled Bayside nursing home; Audubon center won't challenge state license revocation; 161 remaining residents must move to other facilities
Milwaukee Journal Sentinel April 11, 2000

State and federal health regulators moved against Audubon last month after years of serious care problems there.

Punishment comes too late, critics say :: Others tout Florida's aggressive stance
The Florida Times-Union (Jacksonville, FL) June 4, 2000

In 1998, 16 nursing homes had a conditional rating.

But in those two years, the state proposed fining only two Northeast Florida homes.

The state proposed a $ 136,000 fine against Hilliard Manor. The U.S. Health Care Financing Authority imposed a $ 207,000 fine. The state also proposed, and the Health Care Financing Authority imposed, a $ 206,000 fine against Mariner Health of Jacksonville.
Also in 1998 and 1999, the state temporarily banned new admissions to three nursing homes: Hilliard Manor, Holly Point Manor and Southlake Nursing and Rehabilitation Center in Jacksonville. And it temporarily stopped Medicare and Medicaid payments to Avante of Jacksonville Beach, Oak Terrace Specialty Care Center in Green Cove Springs and Mariner Health of Jacksonville.

State Health Department cuts 46 facilities from watch list
The Associated Press State & Local Wire June 24, 2000

Offering few reasons, the state Health Department removed 46 nursing homes from a watch list of troubled facilities.

The new watch list includes just 12 Oklahoma nursing homes and is a draft, according to a letter from acting Health Department Director Jerry Regier.

Of the 12 homes on Friday's reduced list, 10 homes have filed for bankruptcy, with eight of those companies planning to reorganize their debts and continue operations.

The Binger Nursing Center and Silvercrest Manor of Anadarko will cease operations, having filed papers to liquidate their assets.

The eight that will reorganize and keep going are: Cyril Care Center; Integrated Health Services at Bryant Nursing Center, Edmond; Integrated Health Services of Moore; Mariner Health of Bethany; Rosewood Manor, Norman; Stratford Nursing Center; Sunbridge Lodge Care and Rehabilitation, McAlester; and Sunbridge Park Care and Rehabilitation, McAlester.

Two homes on the list - Cheyenne Care Center and Southern Pointe Living Center of Colbert - have been cited for substandard care on three straight inspections.

Mariner turns over eight Wisconsin nursing homes
The Business Journal July 14, 2000

Five Star Quality Care Inc., of Newton, Mass., took over management of the eight (Mariner) nursing homes July 1, according to Evrett Benton, the firm's president and chief executive.
Meanwhile, Five Star has begun correcting many of the patient-care deficiencies and problems cited by state regulators in surveys of Mariner's Wisconsin nursing homes. In April, the state fined one of the homes, River Hills West in Pewaukee, in a case involving a 92-yearold who died of complications of gangrene.

New rules guide senior care Rating system changes for nursing homes in Florida
The Florida Times-Union (Jacksonville, FL) October 11, 2000

About half of the 45 nursing homes in Baker, Clay, Duval, Nassau and St. Johns counties scored worse than the state median. Mariner Health of Jacksonville scored 210, the worst in the region.

American Health Line October 30, 2000

One-third of Colorado's "most frail citizens" reside in nursing homes run by bankrupt companies, the Denver Rocky Mountain News reports.
Furthermore, Colorado inspectors "have sought federal sanctions" on 28 facilities, nine of which were in Chapter 11 (Imse, Denver Rocky Mountain News, 10/22).

While not all the state's "problem nursing homes" are bankrupt, half of the 58 bankrupt homes have been cited in the last two years for "harming patients," the News reports. Last year, complaints about nursing home care to "a network of ombudsmen" increased by one-third.

Feeling strain, nursing home care struggles
The Capital (Annapolis, MD) November 19, 2000

The 67-year-old woman suffered from diabetes, high blood pressure and glaucoma and had endured multiple strokes that left her right side paralyzed. A doctor ordered her strapped into a wheelchair, so there she sat, dependent on the nursing home staff _ and completely vulnerable to her abusive husband.

Workers at Mariner Health of North Arundel in Glen Burnie had been told never to leave the man alone with her. Yet, the man was seen slapping his wife across the face.

It was just one problem at the nursing home this year. A state inspector found inadequate beds and ventilation, medical records that had been tampered with and a patient with a growing pressure wound left untreated for six days.

The situation is not unique.

Plagued by staffing shortages and reeling from cuts in government aid, nursing homes in Maryland are struggling. State and federal reports show a sharp decline in the quality of care, and many problems are going undetected by inspectors.

"We have got to find better ways to care for our elders," said Dennis Steele of Towson, who researches Maryland nursing homes for the Web site Member of the Family. "And that is not happening."

Nursing home closing forces residents out
The Associated Press State & Local Wire January 18, 2001

A nursing home that took in 66 patients six months ago is closing because Medicaid and Medicare reimbursements fell short, its owners say.

Shores Health and Rehabilitation Center will shut down in June, officials with Mariner Post -Acute Network said. The move will force 185 patients to leave.

"It's awful, just awful," said Sue Schroeder, director of the state's nursing home regulatory agency. "No one should have to go through it."

Atlanta-based Mariner is in bankruptcy. The company told Shores residents about the closing Tuesday.

The company also owned the Audubon home in nearby Bayside. Shores took in 66 Audubon patients when the home closed in June after state and federal health regulators shut it down for poor care.

On Wednesday, Magistrate Judge William E. Callahan Jr. issued an injunction compelling Mariner to make all documents about a 62-year-old Audubon patient's death and a 53-year-old Shores man's death available to the Wisconsin Coalition for Advocacy Inc.

Nursing home quality declines Facing a tide of lawsuits and horror stories, the industry says it is working to improve, but the Florida Legislature may not wait
The Florida Times-Union (Jacksonville, FL) April 1, 2001
Marcia Mattson, Times-Union staff writer

The percentage of Florida nursing homes found in inspections to be providing deficient services increased during the 1990s, during the same period in which the percentage of homes violating staffing requirements doubled.
Mariner Health of Jacksonville, a home in North Jacksonville owned by a national for-profit chain, got the worst ranking in Northeast Florida, but was higher than 35 other nursing homes in the state.

Comment:- Note that Mariner came out of bankruptcy under the name Mariner Health Care Inc. in May 2002

By ANDREW JULIEN; Courant Staff Writer

Two more nursing home companies have announced plans to begin hiring permanent replacements for striking workers starting today, bringing to 13 the number of nursing homes where workers are facing the same threat, union officials said Tuesday.
(Union spokesperson) said the threat has been made at nursing homes owned by Kindred HealthCare, Roncalli Health Care and Mariner Health Group, which employ more than 1,000 of the 4,400 or so workers who are striking. The strike is now in its second week.

THE BOTTOM LINE OF CARING: National chains earn poor inspection reports
The Atlanta Journal and Constitution July 28, 2002

* Homes in Georgia: 10
* Headquarters: Atlanta
* Profile: Publicly traded, emerged from Chapter 11 bankruptcy protection in May. Owns, leases or manages homes with about 38,000 beds nationwide.
* Four--year inspection record: Had one--third more violations than the average Georgia home.
* Web site:

THE BOTTOM LINE OF CARING / THIRD IN A SERIES: State pays some nursing homes more than others
The Atlanta Journal and Constitution July 30, 2002

Death uninvestigated When Judy Peacock dropped her mother (Whitehead) off at Brian Center, she had no idea what the home spent on patient care. She didn't realize the home had earned an incentive bonus from Medicaid for low spending on staffing and meals.
The records do not show how much attention she got from the staff or explain the dramatic change in her health in just 12 days there.
Before Whitehead arrived, Brian Center most recently had been cited for numerous problems with cleanliness and upkeep, as well as for failing to perform lab tests. A month after Whitehead's death, on an unrelated visit, inspectors found problems with the way some residents' medications were handled. Six months after Whitehead died, the home was cited for failing to report an incident in which a partially nude employee was caught on top of a 53--year--old woman with Huntington's disease and dementia. The employee pleaded guilty to sexual battery and was sentenced to probation and 30 days in jail. The state did not cite the home for abuse, and it treated the violation as a minor one that caused minimal harm. Mariner Health Care Inc. emerged from bankruptcy protection in May. A spokeswoman for the Atlanta--based chain declined requests for an interview.
She is also troubled by what she found at the home after her mother's death. The pile of new socks that her mother brought with her had never been used. Her false teeth were soaking, and the staff couldn't even find her glasses. "My mother was running around without any teeth and no glasses ------ no wonder she wasn't eating anything," Peacock said, trying to piece together the clues.

"In my own heart," she said, "I feel like they, through neglect, let her die."

Nursing home is sued in death
Fort Worth Star--Telegram (Texas) November 9, 2002

A Fort Worth nursing home where the state found that "low--risk" patients were more likely to have pressure sores is being sued by the daughter of a woman who died after developing

severely infected pressure sores The lawsuit filed in federal court in Fort Worth against Mariner Health of Fort Worth and its parent corporation on behalf of Jo Ann Wilson alleges gross negligence.
The suit alleges that Eugenia Faye Sellers, 90, was malnourished and suffering from seven severely infected pressure sores in her groin area when she was transferred from the nursing home at 4825 Wellesley Ave. to an acute care hospital Nov. 1, 2001.
On Oct. 17, 2001, the agency cited the facility for not having a program "to keep infection from spreading" and found it was a "widespread" problem.
The suit alleges that the nursing home did not have sufficient staff to meet residents' care needs.

Rocky Mountain News (Denver, CO) December 6, 2002

The only nursing home in Craig will be forced to close unless its operators can correct a series of violations. Valley View Manor, which has about 50 residents, has been cited for 16 deficiencies in medical and psychological care, according to Jeanne--Marie Regan of the state health department's Health Facilities Division The statewide average found during such inspections is five to six deficiencies, she said.
- - - Mariner Health Care, the Atlanta--based owner of the nursing home. Chatelle, based in Austin, Texas, said the facility is "implementing a plan of correction.

Comment: A 2003 report suggests that Mariner is still compromising care by understaffing.

A nonprofit organization that advocates on behalf of nursing home residents is suing several long-term care chains over what it claims is inadequate staffing.
Long-Term Care Wire ??? date 2003

The Foundation Aiding the Elderly has filed suit in northern California against Covenant Care California, Kindred Healthcare, Mariner Health Group and Pleasant Care Corp. FATE is seeking injunctions to force the companies to hire enough nursing staff to comply with state law.

"Understaffing of skilled nursing facilities is a deplorable practice, as well as a clear violation of state law," says attorney Mark Todzo of The Lexington Law Group, a San Francisco-based law firm representing FATE.

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