Las Vegas Sun

March 28, 2024

Panel told of patient abuse

CARSON CITY -- A legislative committee has been told that patients with Alzheimer's disease sent to out-of-state facilities under the Medicaid program have been victims of mistreatment, which may have led to their deaths.

Shawna Judd, her voice choking with emotion, said her father was sent to a center in Utah where he was given overdoses of drugs that led to his premature death.

Judd, of Minden, told the Legislative Committee on Health Tuesday she did not want other families to suffer the way her family has.

Sen. Ray Rawson, R-Las Vegas, the chairman of the committee, said committee members would visit some of the places in Utah to see if there is abusive treatment.

Rawson said he was "astounded" by testimony that 75 Medicaid patients with Alzheimer's or dementia disorders who have behavioral problems are transferred to Utah or Idaho. And there are scores of others who are not Medicaid patients who are dispatched out of state because of a lack of beds in Nevada.

Rawson said this practice separates families. He questioned what steps are taken to ensure there is quality care in these places.

Mary Wherry, deputy administrator of the Medicaid program, said Nevada depends on the other states to police the facilities. The other states, she said, have nearly the same standards.

Rawson replied, "It seems like out of sight, out of mind."

Myra Davis, head of the Southern Nevada Alzheimer's Association, told the committee there have been complaints received both in southern and northern Nevada about the facilities in Utah.

Davis said there were 32,000 people in Southern Nevada with Alzheimer's and 28,000 in Northern Nevada. She said 75 percent of them are cared for at home without any subsidy.

Davis and others said there were no Nevada facilities to handle those with Alzheimer's or dementia who have behavioral problems.

Judd said her father was shipped out of state when he became combative at the nursing home in Nevada where he was living. She identified the home and the physician in Utah only as "X" and accused them of providing inadequate care.

Had her father been close to home, this might not have happened, she said.

Charles Duarte, head of Nevada's Medicaid program, said he has tried to persuade nursing homes in the state to take some of these hard-to-manage patients. He has offered extra reimbursement.

He said the nursing homes have refused, complaining they would be faced with the increased potential of being cited by federal and state regulators and then fined. And these facilities said the nursing shortage would limit their ability to care for these types of patients.

The rates for the out-of-state facilities range from $97 to $250 a day.

He cited examples of the types of patients who are sent out of state. There's an ex-boxer with a brain injury who may suddenly punch another resident or staff members. One patient has an eating disorder, eats nearly everything in sight and requires 24-hour monitoring to ensure his safety. Another has sexual aggression and he may try to rape other residents.

Some residents suffer from alcohol dementia and may try to escape to obtain liquor. When denied, they become angry and aggressive toward staff and other residents.

Duarte told the committee his agency is looking for options to keep these patients in Nevada. One might be to entice a company in another state to move to Nevada to operate such a facility. Or the state might provide some of its mental health facilities to a private contractor to handle these cases.

Rawson said the testimony "has opened up a series of issues we had not expected to see."

"It is unusual for a committee to travel out of state," he said. But he wants to schedule a trip to look at the model programs that might be used in Nevada and also to check on any possible abuses of Nevada patients.

archive