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KANSAS CITY, Kan. (AP) – Fourteen hundred afar abroad from her ailing dad, Aliza Katz can almost eat. Her mind’s not absolutely on her work. She doesn’t beddy-bye because of how afraid she is over what’s accident to her ancestor central Village Shalom’s nursing adeptness in Overland Park.



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“When I absolutely go to sleep, I’m accepting abhorrent dreams,” Katz, 53, a built-in of Overland Park active in Bonita Springs, Florida, told The Kansas City Star.



The anatomy of her concern: a letter that blindsided Katz in November cogent her that her father, 80-year-old Norman Bresel – ill with Parkinson’s disease, awkward in his accent and movements and codicillary on a wheelchair – had 30 canicule afore he would be booted from the abode he has alleged home for bristles years.

In official terms, Bresel was actuality “involuntarily discharged” for what Village Shalom wrote was all-important for Bresel’s own “welfare” because he had needs that “cannot be met at Village Shalom.” In a account to The Star, the organization’s admiral and CEO, Matthew Lewis, said that although aloofness laws prevented him from talking about Bresel, the move was in the best absorption of the absolute Village Shalom community.



But Katz, calm with admiral from two Kansas accompaniment agencies who acquire aback brash the matter, don’t acquire that attitude at all, or Village Shalom’s affirmation to move advanced with his removal. They acquire developed assertive that article added is afoot.

“I told them,” Katz said of Village Shalom, “‘Over my asleep anatomy are you activity to bang my ancestor out like some affectionate of dog.’”

Bresel afresh sat in his allowance at Village Shalom, his accent quiet and labored. He has cried in abashing over the anticipation of actuality affected from his home, his babe said.

“It’s appealing difficult to acquire why, all of a sudden, I’ve become a target,” Bresel said. “I aloof appetite to alive my life.”

What Bresel didn’t know, what his babe has alone afresh discovered, is that automatic discharges – accepting ousted or beatific to addition nursing adeptness on alone 30 days’ apprehension – are the arch complaint adjoin nursing homes nationwide.

Complaints, fabricated to the nation’s Long-Term Affliction Ombudsman Program, a arrangement of advocates for nursing home patients, are alone ascent – up from 5.9% of 150,000 complaints in 2011 to 7.3% in 2018, the best contempo year for data.

In its acute form, it is alleged “patient dumping.” Nursing home association brash too difficult or cher to affliction for, or who may pay beneath on Medicaid as against to private-pay residents, are removed and larboard at bus stops – generally and illegally with little or no above-mentioned apprehension – or beatific to emergency apartment for evaluations, and again never readmitted.

“It’s an enormous, adverse problem,” said Kelly Bagby, a carnality admiral of AARP Foundation, area she is a arch advocate in Washington, D.C., for the organization’s activity unit. “People are dumped into nowhere, into motels, hotels, abandoned shelters, but additionally hospitals all the time.”

Since 2017, AARP has connected to activity a California nursing home, Pioneer House of Sacramento, afterwards it beatific an 82-year-old woman, Gloria Single, to be evaluated at an emergency allowance and, then, afterwards warning, banned to booty her back.

Single, who was on Medicaid, had dementia, lung ache and added problems. She lived at the nursing home for bristles years with her 93-year-old husband, Bill. The nursing home maintained that they beatific her to an ER afterwards she became agitated and started throwing artificial utensils. Single, they claimed, had brainy bloom issues and bare to be placed about else.

The nursing home was ordered by the accompaniment to booty Single back, but it refused. Single’s bloom attenuated until, in 2019, she died.

“Her bedmate and her both died cat-and-mouse for us to be able to force the adeptness to booty her back,” Bagby said. “That’s the ancillary adventure here. It’s actual debilitating to be dumped. It’s not aloof about your rights, or your not actuality with your accompany or active in your home. It’s actual traumatizing.”

The activity is ongoing.

“We are determined,” Bagby said. “Our applicant died. We’re activity to bulk out a way to appoint consequences. This can’t be accustomed to stand.”

Katz is angry her dad’s proposed abatement as well.

A above pharmacist and well-regarded bulk in Kansas City’s Jewish community, Bresel has lived in Village Shalom’s nursing units aback 2015. Located at 5500 W. 123rd St., it is a all-inclusive continuing-care circuitous of homes, apartments and apartment for absolute living, assisted living, nursing and anamnesis care. Although it now serves all bodies and faiths, the nonprofit’s roots date to 1902 and the Michael Appleman Home for Aged Jews, again in Kansas City.

Bresel has been blessed at Village Shalom, which agency “peace” in Hebrew. He came not continued afterwards his wife of 54 years, Barbara, died in 2014 while caring for him.

“My mom – absolutely out of the blue, unexpectedly, hadn’t been ailing – actually didn’t appear up to bed one night,” said Katz, who additionally has a adolescent brother, Scott. “My dad came bottomward to acquisition out area she was, and she had anesthetized abroad watching ‘Dancing With the Stars.’”

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Bresel lived for a few months in Florida abreast his babe afore he insisted on abiding home to Kansas City. At Village Shalom, he brand his nurses, caretakers and friends. He appreciates that it ceremoniousness the Jewish acceptance and traditions that acquire abiding him. White and atramentous yarmulkes lie on his nightstand. He attends Jewish casework consistently in his wheelchair.

“All in all, we were actual happy,” said Katz, who said that she did not anticipate annihilation was awry at Village Shalom until July.

Prior to that, Bresel’s sister in Overland Park had had ascendancy of Bresel’s banking and added acknowledged affairs as his adeptness of attorney. But because of illnesses and added affairs in her own family, she had to duke off the role.

Katz aftermost summer was accustomed adeptness of attorney. As the new point actuality attractive afterwards her father’s care, she was arrive by Village Shalom to booty part, over the buzz from Florida, in one of his approved affliction conferences, an amend on how aggregate is going.

“And in that chat for the aboriginal time, I heard the best advancing situation,” Katz said.

She was told that there was a abode that her ancestor had possibly acted in a sexually inappropriate way about a agents member. The accusation was vague. Katz was shocked.

“They kept cogent me, ‘Don’t worry. Don’t worry. It’s acutely common,’” Katz said.

Indeed, the American Parkinson’s Ache Association addendum that actuation ascendancy disorders, alignment from bank to hypersexuality, are acclaimed ancillary furnishings associated with some of the medications acclimated to amusement Parkinson’s disease. Up to 5% of bodies with Parkinson’s apparent in clinics acquire apparent the behavior. So-called ISB, inappropriate animal behavior, is accepted to 7 to 25% of bodies with dementia. The college bulk is apparent amid patients in accomplished nursing units.

Katz still was concerned. “My dad is such a absolute gentleman,” she said.

If her ancestor had acted afield with anyone – and Katz was not accustomed abundant detail to be assertive that he had – it was the arctic adverse of his appearance and how he’d anytime behave. She wondered if whatever occurred was a aberration or a accessible ancillary aftereffect of his admixture of medications:

The allaying Klonopin, the antipsychotic Seroquel, hydrocodone, levodopa for Parkinson’s, the antidepressant Remeron. All told, he could be demography as abounding as 20.

Kansas in 2016 led the nation in the overuse of antipsychotic medications in nursing homes. The bulk of use beyond the country has aback dropped. In 2018, the best contempo year of abstracts aggregate by the federal Center for Medicare and Medicaid Services, Kansas still ranked 12th.

Katz pushed for the nursing home to get her ancestor to a neurologist and psychiatrist. Advocating for his health, she said, “I began to accomplish waves.” A assemblage of emails shows that Village Shalom seemed to be alive to board her.

“I aloof thought, we’ve got to get him in to see some specialists and get this taken affliction of,” Katz said.

Then the letter arrived, giving 30 days’ apprehension and adage Bresel would be beatific to a altered nursing home.

“As I was aggravating badly to advice my dad, they brash us they were blame him out,” Katz said.

Bresel himself alleged the accusation that he was alarming to others “nonsense.”

Patient advocates say that few nursing home association or their ancestors are acquainted that they acquire both the acknowledged appropriate and adeptness to activity automatic discharges. The Nursing Home Reform Act of 1987, able in 2016, guarantees it.

Katz absitively to fight. The law spells out six affidavit that a nursing home can acquittal a accommodating involuntarily:

▪ Nursing home cannot accommodate able affliction for the resident.

▪ Resident’s bloom has bigger so abundant he or she no best needs nursing home care.

▪ Safety of added association or agents are at risk.

▪ Bloom of added association or agents is in danger.

▪ The resident, afterwards actuality accustomed reasonable notice, has bootless to pay for care.

▪ The adeptness closes.

The affidavit for acquittal charge be accurate in the resident’s analytic record. A nursing home can’t aloof say that it no best can accommodate bare care. It has to certificate why it can’t and why addition facility, the one it is appointment the accommodating to, can do what it cannot. Family, or the acknowledged guardian, charge additionally be notified in writing, and abreast of their appropriate to appeal.

Katz asked for aloof that, an abode audition afore a Kansas authoritative law judge, now appointed for March. She alleged the Kansas Appointment of the Long-Term Affliction Ombudsman, allotment of the state’s Department of Administration, which beatific out an investigator.

Christine Mozingo, the ombudsman for Johnson, Wyandotte and Leavenworth counties, visited Village Shalom. She talked to Bresel, advised his medical records.

She begin nothing. “It is our position that there is no accurate acumen – and I was not accustomed any documentation, nor was I told annihilation – that would abutment one of the affidavit to be discharged,” Mozingo told The Star.

She looked in his medical annal apropos the allegations of inappropriate animal conduct. There was no mention. “It was not in his record,” she said.

Mozingo additionally talked to agents about the allegation. “I was told that annihilation like that had occurred,” she told The Star. Her advocacy to Village Shalom was to stop proceeding with the discharge.

Once she met Bresel, she anticipation any angle that he could be a blackmail to agents or others, or that he airish a botheration that Shalom could not handle, was ludicrous.

“When you see him and accommodated him, you’ll get a bigger faculty of the applesauce of the allegation,” Mozingo said. “I mean, he absolutely has some mobility, but it’s somewhat limited. It would be actual accessible for agents to footfall away.”

The Kansas Department of Aging and Disability Services, which oversees nursing homes, beatific out an investigator, too. In its report, the investigator acclaimed that one alone on Village Shalom’s authoritative agents declared that Bresel “would blow agents afield and try to get agents to appear into his room.” And that it had been activity on for a while.

But there was no affidavit in his medical records. No affidavit to beforehand he endangered anyone. And no affliction agents the investigator batten to backed up the allegation. The investigator’s accounting cessation in November:

“The adeptness afield issued a 30-Day acquittal apprehension to (Bresel).”

Investigations notwithstanding, Village Shalom has not backed off. Katz alleged in appearance references for Bresel, who for years ran the Foxhill Pharmacy at 109th Street and Roe Avenue. Four rabbis wrote to Village Shalom’s leadership, including to Lewis, its admiral and arch operating officer.

“Dear Matt,” David Glickman, the arch clergyman at Congregation Beth Shalom in Overland Park, wrote in December. “I am autograph to you out of pastoral affair for Norman Bresel. I acquire never approved to advocate on account of a Village Shalom client, but I am anxious about his abeyant removal…

“The actual foundation of VS is to be a safe anchorage for the best accessible associates of our Jewish community. If there is annihilation I can do to advice this situation, and acquisition a way for Norm to abide a allotment of VS ancestors and community, I would be blessed to be a resource. Surely, there charge be some added avenues that acquire not yet been explored to try to actualize a safe ambiance for all.”

Rabbis Moshe Grussgott and Herbert Mandl of Kehilath Israel Synagogue alleged Bresel in their collective letter “a admired affiliate of the Jewish community.”

“We appropriately feel that it would be the able and ethical beforehand of activity for you to try and analyze every access of achievability for Mr. Bresel to be able to break there,” they wrote

A clergyman from Fairfax, Virginia, David Kalender, wrote to abode for Bresel.

“My mother was a citizen of Village Shalom, active out her final years in the villa,” he wrote, extolling the staff’s affection and care. “Regarding Norman, I appeal you to activity him the same.”

Typically, nursing homes will aback down, stop a acquittal or transfer, already the abiding affliction ombudsman or added agencies actuate there is no accurate foundation for discharge. Village Shalom has not.

“I’ve never apparent an incident,” said Mozingo, the bounded ombudsman, ”where our appointment and KDADS (Department of Aging and Disability Services) are adage there is no acumen for this notice, but they are continuing with it.”

The Star requested an account with Village Shalom’s leadership. In response, Lewis replied that aloofness laws prevented the alignment from acclamation Bresel directly.

“Village Shalom cannot animadversion on any bearings involving a resident, except to affirm that there exists an advancing proceeding afore a Kansas Authoritative Law Adjudicator appointed by the Kansas Department for Aging and Disability Services,” Lewis wrote. “We acquire that the resident’s ancestors opposes this action, but Village Shalom will booty activity in the best interests of our absolute association and all of our association and staff.”

He went on, ”It is the action of Village Shalom, and in accordance with federal regulations, that no citizen will involuntarily leave Village Shalom afterwards affirmation of alteration to a safe home that meets the resident’s needs.”

Legal affidavit filed in beforehand of the audition analyze two caretakers who allegedly will affirm about Bresel’s “inappropriate behavior.” Advocates for nursing home patients said that alike if the behavior can be proven, the nursing home charge certificate all it approved to do to adjust the problem.

If it could not adjust the problem, it cannot aloof canyon it forth to addition nursing facility. It charge appearance how and why addition adeptness is bigger able to affliction for the patient.

“When you acquire addition into your nursing facility, you’re accepting them and creating a home for them,” said Bagby of the AARP. “It’s a charge you’re making. And unless his needs acquire afflicted so badly that they can no best accommodated his needs, again they acquire an obligation to accumulate him.

“There are affairs area actuality a crisis to themselves or others is a absolute thing. They acquire to certificate that. They can’t aloof say it. They acquire to appearance in the medical almanac what they were accomplishing to abode what the crisis is. The aboriginal footfall can’t be blame him out.”

Bresel, in his room, was adamant. “I don’t appetite to leave.”

Although he is a retired pharmacist, Bresel had too little money to allow to abreast pay for abiding nursing affliction at Village Shalom. His affliction and affliction drained his finances. He ultimately spent bottomward what assets he still had to authorize for Medicaid.

Speaking in general, Bagby and added advocates said that for far too abounding nursing homes, money and maximizing profits are at the basis of abounding automatic discharges of Medicaid patients.

The bulk that Medicaid reimburses for circadian affliction is generally decidedly beneath than what best nursing accessories get from those advantageous privately.

“If you acquire a lot of bodies who are on Medicaid and appetite to change what’s alleged your ‘case mix,’” Bagby said, “you acquire to get rid of some of the Medicaid people.”

Kansas accompaniment annal abode that Village Shalom’s clandestine pay bulk for nursing affliction is $353 per day. Medicaid, meantime, pays $239 per day – a aberration of $114 circadian or about $3,400 per month

Medicaid patients like Bresel are accouterment about $42,000 beneath per year than patients advantageous privately.

Bresel believes that money is the prime acumen Village Shalom wants him out. “I can alone accept it’s because of my banking bearings with the company,” he said.

When the letter of acquittal arrived, Katz said she told her ancestor that he was acceptable to appear alive in Florida. Why be in a abode that doesn’t appetite you?

“And he said, ‘No, I appetite to break here. This is my home,’” Katz said. “When these nursing homes do this to the residents, it’s not aloof the citizen that suffers. It’s the accomplished family.

“I had too abounding bodies acquaint me if they get abroad with what they’re accomplishing to your dad, he will die. He’s aloof activity to die. He doesn’t acquire annihilation else. And to me, I wasn’t activity to aloof let that happen.”

Copyright © 2020 The Washington Times, LLC.

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