Is Ardent Health and Rehabilitation part of Ardent Health Services? Who's watching the pharmacies?

SanStone Health and Rehabilitation, if you look them up on Medicare.gov they operated and managed by by Ardent Health and Rehabilitation. The strange thing is Ardent Health and Rehabilitation doesn't seem to own or operate any health and rehabilitation facilities. Why do they need two different names for one company?
The only Ardent on the Securities and Exchange website is Ardent Health Services, located in Nashville Tennessee. Ardent Health Services operates 11 Pharmacies in New Mexico, and fourteen Hospitals including, Baptist St. Anthonies Health Systems in Amarillo Texas, Hillcrest Healthcare systems in Tulsa Oklahoma, and Lovelace Healthcare Systems in Albuquerque N.M..
One would think that the name Ardent would be protected from use by other companies, especially in the health care field. Either Ardent Health and Rehabilitation is part of Ardent Health Services, or the name is not protected. Why does a company in Tennessee own and operate hospitals and pharmacies out West, but nothing locally?
This is an example of why the regulatory agencies are having a hard time keeping up with who is who. Add to that the fact that politicians are constantly cutting the budgets of enforcement agencies to protect their own investments, and you have a perfect example of what is wrong with the system.
Then there are the government contractors that are supposed to insure integrity of the system. How does a company that is competing for the contracts maintain their own integrity? Obviously they are not going to aggressively pursue the very people they work for! Is it a coincidence that Advancemed, the Government contracted Zone Program Integrity Contractor (ZPIC) for Medicare is cant see any fraud?
Next you have on site pharmacy consultants working for one pharmacy, is that not a monopoly. I'm pretty sure the consultants wouldn't be able to keep their jobs filling prescriptions for other pharmacies.
In the case of Hendersonville Health and rehabilitation, the on site pharmacist works for Blue Ridge Pharmacy. The owner of Blue Ridge Pharmacy is part owner of Hendersonville Physicians and Associates, who own Hendersonville Health and Rehabilitation. He is also supervised by two physicians, Dr. Larry J. Russell, Mom's doctor at HHR and Donald L. Culver, who wrote a lot of prescriptions at BeyStone. I overheard one of their reps one day pushing a refill program on a patient at HHR, they went so far as to offer gifts.
I have suspected for some time that Blue Ridge Pharmacy was filling all the prescriptions at all the nursing homes in Hendersonville. I had seen them at HHR and BeyStone, yesterday I saw them on the road and followed them to the Laurels. It just so happens that Dr. Russell is the medical director at The Laurels as well as the supervisor of the owner of Blue Ridge Pharmacy. Is this not a violation of some sort of antitrust law, if not it should be. This is where the politicians are helping them out, changing regulations to make it easy for them to get away with it.
The system is not working, you have one group providing every aspect of nursing home care. I am pretty sure they are also providing the DME's, I just cant prove it yet. There is also one mobile Xray company that seems to be doing all the xrays at the homes. Carol Lloyd Inc. also MMDS is likely the sole provider of mobile Xrays and diagnostics for this particular group. I'm sure there is plenty of "gift" giving in this huge circle of "friends". I'm sure they have each spent the night at one of Dr.Russells lake house or cabin in Gatlinburg.
I would be interested if anyone reading this knows where else Blue Ridge Pharmacy delivers to, you could just leave a comment. More to come.

If Pat McCrory, the Governor of NC doesn't care, where else do you go?

The last several posts were focused on SanStone and their so called "passion that makes us different" campaign. I am still seeing those damn commercials, but it's time to focus a little on the government agencies that oversee the medical industry.
The first complaint I made was to the North Carolina Department of Health Service Regulation. My brother and I made separate complaints with somewhat different issues. The people taking the complaint on the phone seem very concerned , and indicate a willingness to help. They are the only ones in the NCDHSR that show anything other than a sympathetic stand on the side of the nursing home.
After the complaint investigation of Hendersonville Health and Rehabilitation found no deficiencies, we were able to meet with the Western Regional Director, Gail Maloney. Sometime in late February of 2011, several family members met with Ms. Maloney at the Black Mountain office. We were armed with a signed statement from Mom's roommate that disputed the nurses account of the fall. Along with that we had gone through Mom's medical records and had so many discrepancies that we were sure to get results. There was missing medication, and medication records, wrong room numbers and outright false records. Surprisingly at the time Ms. Maloney saw nothing in our stack of papers that was wrong. Ms. Maloney went on to say that there was no one else above them and that there decision would be the last word.
In the meantime I had filed a complaint with the N.C Medical Board against Dr. Larry J. Russell. I alleged that he had not done his job, by not examining Mom after the fall. This was a big issue because of the fact that she had undergone brain surgery only six weeks before. Also the fact that although she had "met her goals" and was scheduled to go home, she died from no apparent reason. Dr. Russell found no reason for an autopsy, so none was done. I wonder if this could be attributed to the fact that he was one of the owners of Hendersonville Health and Rehabilitation ? Of course the N.C Medical board found on reason to even warn Dr. Russell, and went so far as to tell me they would retain these records in the event that they received any further complaints against Dr. Russell. I know for a fact that at least one other person filed a complaint with the NC Medical Board against Dr. Russell, and still no action. This person contacted me from a number on my blog last year.
Next step was a complaint with the NC Board of Nursing filed against Lara Mooney LPN and Susan Habel RN ( the director of nursing at Hendersonville Health and rehabilitation). I received a letter stating that Lara Mooney LPN was "strongly cautioned" but no explanation of what she was cautioned for. It seemed strange that although they found no wrongdoing, Lara Mooney was "strongly cautioned" for something. Several calls and emails later I was eventually directed to the boards attorney for any further questions I had!
Next step was a two hour meeting with an FBI agent in Asheville. Although he was not familiar with health care regulations, he saw plenty of things wrong with what we showed him. He was very pleasant and we thought we were finally going to get someone to actually look at Mom's case. Our relationship lasted for two years and we met one other time with two agents. The outcome of this is still unknown at this point.
You would think that would be the end of it, but not the case. I also contacted my Congressman (Heath Shuler) and he passed our information on to the Centers for Medicare and Medicaid Services in Atlanta. The contact there sent a letter stating that CMS applauded concerned citizens, and they would do a thorough investigation. The letter said they would also be forwarding our concerns to several different places. I never heard from them again, so I contacted the Congressman's office, who contacted CMS. Turns out that somehow our information never made it off the contacts desk.
I think that by now it is obvious that I am persistent. I have also contacted the CCME (Carolina's Center for Medical Excellence), NC State Medical Examiners office, NC Pharmacy Board , ABC News, the Office of Inspector General, three Senators and NCI Advancemed, the Zoze Program Integrity Contractor for Medicare. My brother has requested information from Advancemed two years ago through the Freedom of Information Act, and still has not received a response.
The bottom line is that not one of these contacts led anywhere. The attitude we have gotten could only be described as hostile and uninterested. I have also written to Governor Pat McCrory, and Aldona Wos ( Secretary of the NCDHHS) 

The branch of government that actually investigates fraud, and any broken laws, is the Office of Inspector General (OIG). They are actually a division of law enforcement. The OIG has more work than they can handle. there are so many crooked nursing home owners , the OIG cant keep up. The owners keep changing names and hiding behind several shell corporations. It would be a full time job just to know who owns what on which day.
Then you have people in high places that are owners of the homes. It is not surprising that the laws are tilted to the favor of the homes. There have been law suits that were won, and they cant figure out where to collect the settlement. The whole system needs a serious revamping.
With the current level of political contributions not being regulated, the rich owners of nursing homes can buy just about any politician they want. I'm not sure what they contributed to Governor Pat McCrory, but it was definitely enough to get him to turn his head. He went so far as to refuse Medicaid money for some reason. Could it be that Governor McCrory has something going in North Carolina that he doesn't want someone to know about? I am relatively certain that Governor McCrory's parents would never be caught dead ( pun intended ) in one of the local nursing homes.

More on SanStone, and the passion that makes the difference!

In my last post I mentioned South Village Health and rehabilitation in Raleigh. It is a SanStone property. I found where they had been fined almost $300,000.00 by the CMS. The information can be seen on Medicare.gov, nursing home compare website. Although it shows the fines, there is no information as to what they were fined for.
I contacted Beverley Speroff, the Division Chief of the North Carolina Division Health Service Regulation (NCDHSR). I asked Ms. Speroff why I could not find the fines on their "list of facilities with fines" page. Ms Speroff replied that the fines were imposed by the Centers for Medicare and Medicaid Services (CMS) and would not show on the NCDHSR page.
What it looks like to me is that the NCDHSR does the investigations, but they dont impose the fines. It appears that the CMS Imposes the fines, based on the NCDHSR Investigations. If thats the case it seems they should both post the information. How can the average citizen looking for a nursing home possibly figure this out? How many Government websites do you have to visit to get the whole picture?
Here is the link for the inspection results from the NCDHSR
http://www.ncdhhs.gov/dhsr/facilities/facility.asp?fid=923549

Here is the Medicare.gov (CMS) link. You can click on the penalties tab and see the fines. But there is no explanation. You can also click on the investigations tab and see the latses inspections, none of which explain the penalties.

http://www.medicare.gov/nursinghomecompare/profile.html#profTab=4&ID=345137&Distn=2.7&loc=ROCKY%20MOUNT%2C%20NC&lat=35.9382103&lng=-77.7905339

This system is definately not working. It is set up to be confusing, and without extensive research makes no sense at all. There is no useful information from the State (NCDHSR) or the Federal (CMS) website. Together, they make a little more sense but still not completely accurate. The information on both sites is not updated frequently enough to make an educated decision on what homes are good or bad.
Not only is all of the above an issue, but they can kill people and still operate. All they have to do is pay the fine, and that is a worst case scenario. In most cases, they are written up by the NCDHSR and the deficiencies are majically corrected. Could this be a result of  Governor McCrory's appointed leader of the NCDHSR? Does Governor McCrory personally have money invested in the nursing home industry, or just his friends and contributors? Either way it is obvious that the owners of these places have no fear of any repercussions resulting from their mistakes, even when they result in death.
I have researched many different nursing homes, most are chains run by shell corporations and managed by other shell companies. They change the names of the corporations like I change my socks. It is almost impossible to keep up with them. An example would be Beystone, a SanStone property,  there is Beystone and then there is Beystone new company. This is from the NC Secretary of State Corporations page. I drove by their listed address and it is a FedEx office on Airport road in Arden. It all seems so sketchy simply because it is. These people know how to work the system and if they dont, they just pay someone to change it.

SanStone Health and Rehabilitation , True lack of passion revealed!!

I keep seeing those damn commercials " SanStone It's our passion that makes the difference". Well today I decided to do some research on SanStones supposed passion. I went to Medicare.gov, the site that rates nursing homes. Each home is evaluated and given a star rating, the ratings don't seem to reflect the NCDHSR inspections, so that part is still a mystery. The star rating is, one for the lowest, and five for the highest. Anyway here is a list of SanStone properties and their star ratings as of today.

Hendersonville Health and Rehabilitation   3 stars : One inspection in 2014 with five deficiencies .

BeyStone Health and Rehabilitation   3 stars  : One inspection with no deficiencies found ?

StoneCreek Health and Rehabilitation  5 stars  : One inspection with three deficiencies.

Anson Health and Rehabilitation  2  stars  : One inspection with three deficiencies .

Madison Health and Rehabilitation  3 stars  : One inspection with four deficiencies .

Oak Forest Health and Rehabilitation  3 stars : One inspection with four deficiencies .

Sanford Health and Rehabilitation  3 stars  : One inspection with four deficiencies .

South Village Health and Rehabilitation  1 star  : One inspection with no deficiencies . Three complaint investigations with three deficiencies resulting in resident death!

Now here is a list of deficiencies at SanStone properties. Take notice of the violations concerning administration and storage of  drugs.

1. Failure to : Conduct initial and periodic assessments of each residents functional capacity.
2. Make sure services provided by the nursing facility meet professional standards of quality.
3. Provide necessary care and services to maintain the highest well being of each resident.(3)
4. Make sure that all resident's drug regimen is free of unnecessary drugs.
5. each residents entire drug regimen is managed and monitored to achieve highest well being.
6. Make sure all residents are safe from serious medication errors.
7. Give each resident a notice of rights, rules, services, and charges.
8. Maintain drug records and properly label drugs according to accepted professional standards.(2)
9. Keep accurate, complete, organized clinical records on each resident that meet professional standards.
10. Store, cook and serve food in a clean way. (3)
11. Immediately tell the resident, doctor, and a family member of any situation affecting resident.(3)
12. Provide housekeeping and maintenance services.
13. Allow the resident the right to participate in the planning or revision of the residents care plan. (2)
14. Try to resolve each residents complaints quickly.
15. Reasonably accommodate the needs and preferences of each resident.
16. Keep medication errors to less than 5%.
17. Give resident proper treatment to prevent new pressure sores or heal existing pressure sores. (2)
18. Safely provide drugs and other similar products available, which are needed every day and in emergencies by a licenced pharmacist.
19. Assist those residents who need total help with eating, drinking, grooming, and personal and oral hygiene.
In one of the cases at South Village , the resident actually died.

Is that what sets SanStone apart from other homes? " Passion, that's what makes the difference." Maybe if the spent their money on staffing their properties instead of advertising and sponsoring events, they could actually provide adequate care.

"SanStone It's our passion that makes us different". Go see for yourself their "passion" in action.

I am still having difficulties with hearing the SanStone commercials on WLOS channel 13. "SanStone Health, It's our passion that makes us different." Different from who would be the question. All you have to do is look at the ratings on Medicare.gov, and you will see they are no different from any of the other homes. It is somewhat confusing how they maintain a average rating, with all that passion. I'm sure it has to do with the help they get from their friends at the NCDHSR. It's not like they don't get complaints against SanStone properties, It's just that none of the complaints are substantiated. It's not like they don't get written up occasionally in the yearly surveys either. The answer to complaints and surveys both is the same, "defficiencies corrected."
I just went to Medicare.gov and they don't even show the corrections anymore. They tell you to call the home for plan of correction
I'm not sure how much they pay those elderley folk in their commercials to say how wonderful they are, but they are obviously not residents at Hendersonville Health and Rehabilitation. I've been in there and what I saw was certainly not Passion.
I saw people laying in their own urine and feces. I saw residents wheeled down to therapy an hour early, just so someone would be watching them. I saw residents sitting in the hall and dining room in wheelchairs waiting for someone to take them somewhere. What I did not see was passion.
While visiting a friend one day, he had an accident while in his wheelchair. I pushed the call button and waited, eventually I went to the nurses station and asked the person at the desk if someone could come clean him. My friend was sitting in a wheelchair in a pool of his urine for more than 20 minutes. I know the time because when he was wheeled in they said he needed to sit up for half an hour. On a subsequent visit they were discussing a pressure ulcer. Sitting in urine for twenty minutes definately doesn't help a pressure ulcer.
The staffing levels would make it impossible for the staff to be passionate. A person that is overworked and underpaid is not a model for passion. The people who show passion are the ones trying to sell you on the place. The residents I visited were both Medicare patients, it is possible that they have a hall where they put private pay residents where they are treated different.
The bottom line is that the patients I've seen in Hendersonville Health and Rehabilitation need compassion. Maybe they should change their slogan to - " Money, that's our passion". WLOS will let them say whatever they want as long as they pay. It seems a little suspicious that WLOS is in the same complex as the SanStone corporate office. Although the mailing address of SanStone is actually a Fed - X office on Airport Road, I've seen the office in Biltmore Park.
The dictionary defines passion as "an intense desire or enthusiasm for something", I guess if they don't say what they are passionate about, they can't  be sued for perjury. Just walk in to Hendersonville Health and Rehabilitation and look for passion. There has to be a special kind of place for these profiteers in the afterlife. Maybe then they will learn what passion is.

SanStone, BeyStone, Hendersonville Health and Rehabilitation. The NCDHSR has given them a liscense to kill. Corruption????

I have been writing this blog for three years now. In that three years I've had to look at things that are extremely unpleasant. I have spent hours going through Mom's medical records, and reliving the nightmare of the last days of her life. The more I read the more I am convinced that her death was a result of something that happened at Hendersonville Health and Rehabilitation. I am also convinced they have fired or promoted anyone who could provide answers. They will never let the truth out. I can prove that Lara Mooney LPN, lied in her nurses report. She is now working at Fleishers Fairview Healthcare, beware of nights if you have a loved one in there.
It has become obvious to me that the NCDHSR, has assisted in the witholding of the key facts surronding the last days. I have been focusing on the reports of the investigation that was supposedly done by the NCDHSR. One thing is for certain, Hendersonville health and Rehabilitation and SanStone, the operator of HHR, have friends in the NCDHSR. While looking at the complaint I filed, and the response to the investigation, it is apparent that they knew just what to write. Even Dr. Larry Joe Russell, he just happens to put a sentence in there about " if she fell and hit her head". Why is he mentioning her falling and hitting her head. The only people who I mentioned her hitting her head to was the NCDHSR. Complaints are confidential, so where did he get that information?
I would be surprised if Governor McCrory isn't on their payroll, I'm sure they contributed to his campaign. I have written to our fair Governor asking for his assistance with the NCDHHS. I wasn't really expecting a reply, due to his relationship with Secretary Aldona Wos, so I wasn't disappointed when I didn't get one!
Is there corruption in the State of NC, DHHS, Is there a special relationship between Governor McCrory and SanStone? Could it be that our Governor turned down the Medicaid money, just to avoid the scrutiny it may bring? All I know for sure is that NCDHSR is protecting Hendersonville Health and Rehabilitation. They gave them all the answers to keep anyone else from being suspicious. Then earlier today I was looking at Medicare.gov and saw a complaint investigation done at BeyStone. The patient was signed out on a leave of absence from BeyStone on December 22, 2010. On December 25,while on release from BeyStone, she was involved in a motor vehicle accident. She was treated and released from Park Ridge Hospital back to BeyStone that same day with specific directions on necessary care for the next three days. The directions were not followed, and the patient was readmitted to Park Ridge Hospital on December 27, 2010. The patient died on December 28, 2010. This is a patient that was out on release only two days before.
The complaint investigation basically acknowledges that BeyStone did not follow through with the directions from the hospital. It also basically gives them a get out of jail free card with the customary defficiencies have been corrected line. Does that mean that the patient was brought back to life? There was no penalty assesed, and the patients doctor said it wouldn't have made any difference anyway? I would almost bet my life that the doctor was Larry Joe Russell, a trip to the Henderson County Courthouse and I will know for sure. I will post a copy of her death certificate and the signing doctor my next post. More to come.
Here is the link to the BeyStone complaint. Watch out Mills river, The Lodge is coming in March and itt is going to replace BeyStone.
http://www.ncdhhs.gov/dhsr/facilities/nh/20110718-943389.pdf

Hendersonville Health and Rehabilitation and NCDHSR corruption? Three long years and no closer to the truth.

Recent events have forced me to reexamine the facts surrounding the death of my Mother. I have been sorting through medical records, letters, articles and my notes.
The first and probably most alarming thing is the poor records kept by Hendersonville Health and Rehabilitation. If you think about medical records, what would you think is important? I would like to think that they had my personal information correct on the admission documents.
In Mom's case they had the wrong room number on most of the documents ! How many ways could that be a problem ? Well they could easily administer the wrong medication, give the wrong food ( mom had food allergies), not provide the required assistance in ambulating, the list goes on and on. The bottom line is in a nursing home, if you don't know who you have in what room and bed it could be a catastrophic.
In nursing homes the staff changes on a regular basis, especially the cna's  who provide the majority of care. If the records don't match the patient, who is going to notice. With staff levels at the bare minimum or even below in some instances, they wouldn't even have time to check.
Next you would want to know that there were enough staff to provide necessary care. It is alarming to learn that there are no rules dictating number of patients to staff on each shift. There are some industry standards, but at Hendersonville Health and Rehabilitation, they have ways to get around those.
Obviously there would be more staff present in the daytime hours. You would have the physical therapists, dietary aides, housekeepers, along with the nurses, doctors and cna's. That said, you would think the level of care would be better during the day. That is not necessarily the case. Consider that during the day they need to change the sheets, bathe the residents and assist with basic hygiene, help them get dressed, get them to therapy and so on. At Hendersonville Health and Rehabilitation, they use the physical and occupational therapists to do many of things the nurses would do. They give showers, assist with hygiene, get patients out of their rooms and into therapy rooms, allowing for the changing of bed linens.
The most infuriating thing is the actions or lack of action by the NCDHSR. The NCDHSR is a division of the NCDHHS that licenses and does complaint investigations in nursing homes. The number of complaints that are substantiated by the NCDHSR is minimal. I have a copy of the so called investigation of my complaint and there are mistakes and outright lies throughout the report. It is apparent after three years of research that their findings are where other agencies stop. If the NCDHSR doesn't find any substantiated complaints, no one will look any further.
I'm convinced that the NCDHSR is in the pocket of the wealthy nursing home owners. The evidence is there to substantiate complaints but not if no one looks. Is someone at the NCDHSR benefitting from turning the other way. Is it possible that the Governor of the State of North Carolina is turning a blind eye. After all he is the one who appoints the secretary and big shots at the NCDHHS. Could it be that the reason our Governor turned down the Medicaid money is the fact that it would bring more scrutiny to the investigations?
I don't know any of this for sure, but I believe that anyone looking could find out who is benefitting from the inadequacy of the NCDHSR and the NCDHHS. I contacted the Governor two weeks ago regarding the NCDHHS, and never received a response. Actions speak louder than words