Articles Posted in California Department of Public Health

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In a strongly worded report, the California Senate Office of Oversight and Outcomes recommended major reforms to the California long-term care ombudsman program. The responsibility of the Ombudsman program is to investigate and resolve complaints made by individual residents in nursing homes.

According to the California Advocates for Nursing Home Reform (CANHR), nursing home and assisted living facility residents in California at an increasing risk of elder abuse because ombudsman funding has been severely cut and the state ombudsman office has established unreasonable restrictions on ombudsman reporting of abuse.

The state report, entitled California’s Elder Abuse Investigators: Ombudsman Shackled by Conflicting Laws and Duties, revealed that ombudsman complaint referrals to the nursing home licensing agency dropped by a stunning 44 percent in the last year after the Governor Schwarzenegger slashed funding to the fledgling ombudsman program. Assisted living facilities have been affected as well. During the same period, complaints by ombudsman to California’s Community Care Licensing regarding assisted living and residential care facilities also dropped by more than 40 percent.

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Tri-City Hospital in Oceanside was fined $25,000 by the California Department of Public Health for “failure to ensure the health and safety of a patient” who fell out of bed and fractured her hip. The hospital has modified its policies as a result.

According to reports, a 91-year-old woman who was admitted to Tri-City on December 7, 2008 because of a stroke, and paralysis on her right side, fell out of bed two days later and fractured her hip. She was taken to surgery for repair of the hip, and died the following day in the ICU.

The state investigation revealed that upon admission to the hospital the woman was rated as a high risk for falls; a rating that would require a series of interventions such as bed alarms, padding on the floor around the bed, etc. The investigation revealed that “there was no evidence in the medical record to support that these interventions were in place at the time (the patient) fell.

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A Tracy, California nursing home received a $100,000 fine and a AA citation, the state’s most severe, after it was determined that the death of a 78-year-old resident was due to nursing home malpractice. The nursing home staff failed to monitor the woman’s medication and failed to send her to the hospital when her brain started to bleed.

According to the report, the resident had recently received an increase in medication to prevent clots. With the medication came a potential for internal bleeding. Shortly after increase in dosage, the woman began to slur her words and complained of a headache. She kept saying, “My head, my head…” But nothing was done.

Several hours later the resident was semi-conscious, waking only to vomit. The family complained to the home that something was not right, but failed to take the matter seriously. The woman was eventually transferred to the acute-care hospital, but it was too late. She died in the emergency room.

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A bill that will increase fines from $6,000 to $10,000 for individuals found guilty of placing an elderly person (over age 65) or a dependent adult in a situation where death or great bodily harm is likely has been signed by Governor Schwarzenegger. The bill, which will take effect January 1, 2010, will also increase penalties for those placing seniors in dangerous situations that are not likely to cause death or great bodily harm.

The new law was supported by Sen. Jenny Oropeza, who acknowledged that “Elder abuse for far too long has been a hidden, pervasive and deadly crime where out of 5 million recent cases, a shocking 84 percent went unreported.” Under the new law, she said, “California’s senior citizens and their families will rest easier knowing that my new law will help protect them from abuse.”

Source: Long Beach Press-Telegram

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Every year, nursing homes throughout the state of California are fined for deficiencies found in state investigations, frequently related to nursing home care. The fines range anywhere from a Class B fine of $1,000 to an AA citation of $100,000, as was recently issued against the Encinitas nursing home Aviara Healthcare.

But California officials concede that collecting these fines can take years, if they are collected at all. Nursing homes have a right to appeal fines that are issued, and most do. In the year 2007, the state issued more than $2 million in fines and to date has collected less than 10 percent.

The California Department of Public Health is charged with the oversight of skilled nursing facilities, and is the state department that issues and collects nursing home penalties. They simply don’t have the manpower to get the job done.

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The California Department of Public Health has issued fines to two Orange County nursing homes after concluding that negligent nursing care lead to the deaths of two residents. Alamitos West Health Care Center in Los Alamitos was fined $100,000.00, and Huntington Valley Healthcare in Huntington Beach was fined $80,000.00.

Investigators found that Alamitos West failed to give an 82-year-old female resident adequate fluid, causing her to suffer dehydration and kidney failure. When the woman was finally transferred to a hospital, her dehydration had caused an altered mental status. The woman died a week later, on Christmas Day.

The case against Huntington Valley involved the failure to call 911 as a patient was dying. According to reports, the caregiver thought the resident did not want resuscitation if life saving treatments was needed, but the resident had actually stated in his chart “I Do Want C.P.R.” The resident died in the nursing home.

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This list contains the issuance of citations to Southern California nursing facilities by the California Department of Public Health over the last six months. All the citations listed are issued for reasons related to patient care. For verification of the citation, please contact the local department office or Walton Law Firm LLP.

<font size='2'Facility Date Citation
Los Angeles County
Antelope Valley Healthcare 3/04/09 Class B
Arbor View Rehabilitation 3/11/09 Class B
Burbank Healthcare and Rehab 3/04/09 Class B
Casa Bonita Convalescent 3/31/09 Class AA
Chandler Convalescent 2/04/09 Class B
Country Villa Broadway 3/02/09 Class B
Emeritas at San Dimas 3/30/09 Class A
Lutheran Health Facility 3/04/09 Class B
Mid-Wilshire Health Care Center 2/02/09 Class B
Royal Oaks Convalescentr 3/13/09 Class B
Tarzana Health and Rehab 4/07/09 Class B
Windsor Terrace Healthcare 2/09/09 Class B
Orange County
Coastal Communities Hospital 03/17/09 Class B
Country Villa Laguna Hills 03/03/09 Class B
Fountain Care Center of Orange 4/07/09 Class B
Sunbridge Care and Rehabilitation 1/21/09 Class A
Riverside County
Hemet Valley Healthcare Center 2/10/09 Class A
Hemet Valley Medical Center 12/04/08 Class A
Plymouth Tower 1/13/09 Class B
San Diego County
Care With Dignity Convalescent 2/11/09 Class B
Escondido Care Center 02/25/09 Class AA
Fallbrook Hosp. Dist. Skilled Nursing 3/02/09 Class B
La Paloma Healthcare Center 3/04/09 Class B
Remington Club Heatlh Center 3/18/09 Class B
Vista Knoll Specialized Care 3/04/09 Class B
Ventura County
Brighton Gardens of Camarillo 3/09/09 Class B, WMO
Camarillo Healthcare Center 3/09/09 Class B
Country Villa Oxnard 10/30/08 Class B
Fillmore Convalescent 4/03/09. Class B
Twin Pines Healthcare 3/09/09. Class B
Santa Paula Healthcare 3/17/09 Class B, A, A, A

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

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The California Advocates for Nursing Home Reform (CANHR) have issued a press release addressing a Santa Monica nursing home that has neglected residents with impunity, and contending the state has done little to correct the problems. In the release, CANHR contends that a resident died while staff ignored breathing problems, another died from an infected bed sore, and a third was hospitalized with a neglected pressure ulcer, yet the home received no serious penalties from the California Department of Public Health who verified the neglect.

CANHR’s concern about this is shared by many, including this law firm. We have had several cases of outrageous acts of abuse and neglect that have confirmed by the state investigation, but no serious penalties issued. Take for example a case we recently accepted. An elderly Alzheimer’s patient is given a bath by caregivers at the nursing home where she resides. Because of her disease, she tends to resist care, and did resist when five caregivers tried to put her in the bath. One caregiver got so angry that she punched the resident in the face, causing a black eye and severe bruising. The resident couldn’t complain because she cannot speak (because of her disease).

When the family asked why mom had a black eye, the facility lied and said she fell. It was only after one of the caregiver’s conscious got the best of her when the incident was reported to the state. The state investigated and confirmed the abuse, but did the state issue a citation? Of course not; only a deficiency, and not for the physical abuse itself, but for the failure to report the abuse. But maybe the State didn’t think the resident was actually “punched” or “struck” by the nursing; it doesn’t use those words in its investigation report. Instead it says that the nurse “put her fist to the patient’s face.” No punch, no citation, no fine.

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A Pico Rivera nursing home has been issued a $100,000 fine and an AA citation for the death of one of its residents in December. The California Department of Public Health announced that the citation was given to Riviera Healthcare Center on Telegraph Road after a 64-year-old man lit himself on fire while trying to light a cigarette.

According to reports, the resident, who was confined to a wheelchair after suffering a stroke, was left unattended in the dining room. When he caught fire, staff was alerted, but panicked, and failed to use a fire extinguisher and fire blanket that was just six feet a way.

The man was rushed to the nearby hospital with third-degree burns to his legs, groin, butt and hand. Skin grafts were attempted, but failed to take and the man died 18 days later.

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Escondido Nursing Center received the state’s most severe citation – a AA – after the choking death of an elderly resident. According to reports, the 180-bed facility failed to modify the resident’s nutrition plan after his physician placed him on a special diet because of chewing and swallowing difficulties. During lunch on November 30, 2008, the resident suffocated when food got stuck in his wind pile. He had been given beef and carrots.

Class AA citations are relatively rare in California, with only about 20 being issued annually. In our view, this isn’t enough. As nursing home abuse and neglect attorneys, we have investigated numerous horrendous cases of neglect similar to this one (actually, many are worse), where an investigation is completed by the California Department of Public Health and no citation is issued. This may be a good sign that the new leadership at CDPH is changing the culture and encouraging the department to be more willing to enforce California state law as the people expect.

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