Articles Posted in CANHR

After 15 years of bouncing from nursing home to nursing home, and living with the indignities, the mother of a quadriplegic and brain injured daughter had had enough. On Sunday, September 13, Diana Harden wrote a note to a television news station exposing the problems she encountered trying to care for her daughter, then went to the nursing and shot her daughter to death, before turning the gun on herself.

In her letter to ABC news in the San Francisco Bay area, Harden spoke of the years of abuse and neglect her daughter endured in her nursing home. Yvette Harden, suffered a major brain injury and quadriplegia in a car accident 15 years earlier, and spent the last six years at the Oakland Springs Care Center. Oakland Springs is a nursing facility that had 54 complaints lodged against it in 2008 (which is an astonishing amount), and hundreds of deficiencies.

The letter attempts to explain, “the deaths of my daughter and myself.” In it, Harden says that that nurses called her daughter a “big fat pig,” and that they would “wash her like a car” in the shower. To punish the daughter, Harden claims, the water would be turned cold until she screamed. As a result, Harden wrote that her daughter has been “begging” her to end her life for over two years. The stress was too much.

Los Angeles – The death of an 88-year-old nursing home resident has resulted in an AA citation and a $100,000 fine, the most severe penalty that can be imposed by California regulators. The California Department of Public Health issued the penalty after it concluded that nursing home resident’s death was the result of neglect.

According to reports, the resident had received a gastrostomy tube (or g-tube) for feedings on August 29, 2008 and was admitted to Arbor View nursing home on September 3, 2008. The feeding tube became dislodged approximately one week later, and a nurse attempted to reinsert it. Unfortunately, the nurse missed the stomach, and instead inserted the tube into the abdominal cavity. Feedings were then continued.

The next day, the resident was rushed to the hospital with nausea and vomiting, and a scan revealed the problem. She had massive amounts of feeding material in her abdominal cavity that doctors tried to remove. The elderly resident contracted an infection and died shortly there after.

Last Friday, Governor Arnold Schwarzenegger signed Assembly bill 392, which provides funding for California’s long-term care ombudsman programs. The bill does not restore entirely the cuts that were made last year, but the $1.6 million appropriation to approximately 36 agencies throughout the state will provide sorely needed money to programs that, only weeks ago, were on the brink of dissolution.

“This legislation could make the difference between life and death for nursing home patients facing abuse or neglect. Now patients and their families who depend on the Ombudsman to monitor facilities and investigate key complaints can rest a little easier,” said California Assembly member Mike Feuer.

Last year’s cuts were exemplified in several high profile cases of nursing home abuse and neglect. In June 2009, a nursing home facility owner and a caregiver were arrested on suspicion of criminal abuse and neglect when a resident suffered from pressure sores so severe they led to a fatal infection.

Unlike nursing homes, residential care facilities or assisted living facilities are not subject to the same regulation and government oversight. One can’t simply log on to the myriad of nursing home evaluation websites to look at the latest inspection reports or complaint investigation. So how do you adequately evaluate a residential care facility before moving in?

The California Advocates for Nursing Home Reform provide many excellent resources for individuals and families making the tough choices about custodial care, including an evaluation checklist for those considering residential care:

Review Complaint and Inspection Information: The local office of the California Department of Social Services will have information about the latest government inspection and complaint investigations. Unlike skilled nursing facilities, residential care facilities are only inspected every five years so the information may not be fresh. Pay particular attention to any violations of resident’s rights or abuse allegations.

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.

California law allows the creation of “family councils” by relative of a nursing home resident to help influence the quality of care given to a resident. Not merely gripe sessions, these councils can facilitate communications between families and residents with the nursing home staff and caregivers, and also offer peer support for friends and relatives of the resident, and help prevent substandard care.

A nursing home may not prohibit the formation of a family council, and must allow the council to meet on the grounds of the facility at least once a month. In addition the home must designate a staff member who is responsible for assisting the council, and to respond to all written requests made by the council.

The California Advocates for Nursing Home Reform provides excellent resources for the creation and maintenance of a family council, and advice as to how the make the council an effective tool to promote high quality care. (Click here to access the CANHR site)

The California Advocates for Nursing Home Reform (CANHR), a statewide advocacy organization dedicated to improving care for California seniors, has launched a weekly radio program for seniors. The show is called Elder Issues and Answers, and his hosted by Pat McGinnis and Prescott Cole. The show airs Saturday mornings at 9:30 am, can be heard online at KTRB860.com. (Click here to listen)

McGinnis and Cole are leaders with CANHR, and are experts in the areas of elder care. Upcoming shows will feature guests, and will cover such topics as trust mills, nursing home abuse and neglect, financial elder abuse, reverse mortgages, resident’s rights, and Medi-Cal Recovery. Tune in.

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.

Many nursing homes are now marketing themselves as “rehabilitation” facilities in an effort to attract the ideal resident: one who stays under 100 days then goes elsewhere. Why? Because Medicare provides lucrative fees for skilled nursing care. It is not uncommon for nursing homes to discharge residents, often prematurely, when the Medicare benefits end.

Most people are unaware that when Medicare coverage ends, a resident who needs skilled nursing care has a right to stay, either by paying privately, or qualifying for Medi-Cal coverage. Under Welfare and Institutions Code section 14124.7, no nursing home that accepts Medi-Cal payments can evict, or transfer within a facility, any person who changes the manner of paying from private or Medicare to Medi-Cal.

For more information on discharge and transfer rights in California nursing homes, see the fact sheet provided by California Advocates for Nursing Home Reform.

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
Briarcrest Nursing Center 10/28/08 Class A
Casa Bonita 12/09/08 Class A
Casa Bonita 12/19/08 Class AA
Chatsworth Park Care Center 12/22/08 Class B
Country Manor Healthcare 11/21/08 Class B
Del Rio Convalescent 10/10/08 Class B
Hillcrest Care Center 7/28/08 Class B
Inglewood Health Care Center 11/18/08 Class B
Santa Monica Health Care Center 12/05/08 Class B
View Park Convalescent Center 01/12/09 Class B
Windsor Convalescent North Long Beach 09/25/08 Class B
Orange County
Anaheim Crest Nursing Center 01/30/09 Class AA
Flagship Healthcare Center 01/06/09 Class B
Palm Terrace Healthcare & Rehab Center 12/22/08 Class A, B
Riverside County
Extended Care Hospital Riverside 12/04/08 Class B
San Diego County
Care With Dignity Convalescent 11/06/08 Class B
Carmel Mountain Rehabilitation 01/07/09 Class B
La Jolla Nursing and Rehabilitation. 12/12/08 Class B
Ventura County
Camarillo Healthcare Center 12/18/08 Class A
OakView at University Village 1/28/09 Class B
Shoreline Care Center 1/28/09 Class B
Camarillo Healthcare Center 12/18/08. Class A
Victoria Care Center 12/18/09 Class B

 

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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