Articles Posted in Elder Abuse

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The Des Moines Register reviewed 81 bonus payment programs in over 30 states and found that numerous nursing homes with a below-average care giving rating were receiving quality-of-care bonuses. The newspaper looked at eight federal bonus programs in states where regulatory violations by a nursing home do not automatically disqualify a nursing facility from receiving a bonus. The eight programs analyzed are costing taxpayers $313 million per year.

By way of example, the Grace Living Center in Oklahoma earned approximately $96,000 in bonuses during the last year despite federal records that show the home has been cite for more violations than the state or national averages. Toby Edelman of the nonprofit Center for Medicaid Advocacy called the bonuses “preposterous,” and pointed out the incongruity of the government taking money from bad facilities by issuing fines, then returning the money in the form of a bonus. “It just doesn’t make any sense,” Edelman said, “it’s totally confusing to consumers.”

Legislation approved earlier this year says the bonuses will continue at least through June 2009.

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A study just released by the Inspector General of the Department of Health and Human Services reports that 94% of all nursing homes nationwide were cited for violations of federal health and safety standards during 2007. Approximately 17% received deficiencies or citations for issues which caused “actual harm or immediate jeopardy” to residents. These deficiencies were for such things as bedsores, medication errors, lack of nutrition/dehydration, abuse and neglect of residents.

In total, inspectors received 37,150 complaints nationwide. Surprsingly, only one-fifth of the verified complaints involved the abuse or neglect of patients. The remainder were for adminsitrative issues or those related to the physical premises.

Another telling statistic is that 94% of for-profit nursing homes were cited whereas only 88% of non-profit nursing homes were cited. For-profit also received an average of 7.6 deficiencies per home whereas non-profits averaged 5.7 per home.

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The New York Times is reporting this morning that 90% of all nursing homes were cited for violations of federal health and safety standards. Approximately 17% of U.S. nursing homes had deficiencies that caused actual harm. As mentioned in this blog previously, nursing facilities that operate “for-profit” were more likely to have problems than non-profit homes.

Federal inspectors received 37,150 complaints in 2007 about nursing home conditions, the bulk of which involved bed sores, abuse and neglect of residents, medication errors, and nutritional issues. Failure to sufficiently staff was noted as a particular concern in the report, including the allegation that nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” Not surprisingly, researchers learned that elderly patients receive better care at homes with a higher ratio of nursing staff members to patients.

The U.S. has approximately 15,000 nursing homes, housing nearly 2 million people. Under the laws of most states, including California, these homes are inspected once a year.

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On Wednesday, the Senate Finance Committee approved two bills which will help prevent neglect and abuse of elderly persons.

A frequent source of abuse are caregivers who are repeat violent offenders. A bill (S 1577), sponsored by Sen. Herb Kohl (D-Wis.), would create a nationwide background check system to screen long-term care employees for a history of abuse or a violent criminal record prior to hiring.

A seven-state pilot program established under the 2003 Medicare law already exists and would be expanded by this bill. The bill would provide as much as $160 million in grants over three years to states which seek to participate in the program. This law would help keep violent offenders from working in nursing homes with particularly vulnerable elderly patients.

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Yesterday, the U.S. Census Bureau reported the number of citizens age 65 and older will more than double from their current number of 38.7 million to 88.5 million in 2050. The population of 85 and older is predicted to triple in number to 19 million from 5.4 million during the same period.

At the same time, the “working age” population, i.e. those aged 18 to 64 is expected to decrease to 57% of the popoluation from 63% currently. What this means is that there will be fewer people available to care for more elders. Will this cause an increase in nursing home abuse and/or neglect?

As any attorney who represents elders in elder abuse or elder neglect cases against nursing homes will tell you, the number one direct cause of elder abuse is a lack of staffing. Most elder abuse does not occur because the caregivers want to abuse/neglect their residents. It occurs because there aren’t enough caregivers to perform all of the necessary tasks.

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A University of Chicago study reveals that approximately 13 percent of elderly Americans experience some sort of mistreatment. The most common form of abuse was verbal, experienced by 9 percent of elderly Americans, then financial mistreatment, experienced by 3.5 percent, and then physical abuse, reported by .2 percent of the elderly.

“The population of the country is aging, and people now live with chronic diseases longer. So it’s important to understand, from a health perspective, how people are being treated as they age,” said lead author Edward Laumann, the George Herbert Mead Distinguished Service Professor in Sociology at the University of Chicago.

The study revealed variations in the abuse, depending on age and ethnicity, and females were twice as likely to report verbal mistreatment.

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Despite having the same odds at recovery, elderly trauma patients are being steered away from top trauma hospitals while younger patients are getting the better care. A new study finds emergency medical personnel are systematically discriminating against seniors. The study examined 10 years of data from ambulance trips in the state of Maryland and found that nearly half of all patients over 65 were not sent to designated trauma centers for care compared to only 18% of younger trauma victims.

 

Walton Law Firm LLP represents people who have been vicimized by elder abuse, elder neglect, mistreatment, and nursing malpractice. Cases are accepted in the counties of San Diego, Los Angeles, Orange, Riverside, San Bernardino, Ventura, and Imperial.

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Elder abuse lawyers have all seen cases of residents being evicted from nursing homes, or refused readmission, for dubious reasons. We sometimes call it Medi-Cal prejudice; that is residents being refused admission to a nursing home for no other reasons than they are Medi-Cal recipients.

One former client of our firm called a nearby nursing home hoping to find a room for her mother, who was about to be discharged from the hospital. The first question from the nursing home was whether her mother was receiving Medi-Cal. Medicare, or private pay. When the daughter told the nursing facility her mother received Medi-Cal, she was promptly told there were no available beds, but that her mother could be put on a waiting list.

Homeless.jpgBeing a nurse herself and believing there were available beds, the daughter called the same facility the following day to see if there was room for her mother. Using a different name, she again asked if there were available beds, and this time, after informing the nursing home her mother received Medicare, she was told there were several rooms available, and that the facility would be happy to provide a tour that afternoon.

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We are frequently asked how nursing home neglect or abuse can be prevented. There is no magic answer, but there are things one can do to lessen the odds that a loved one will be subject to physical neglect, financial abuse, or suffer the decline in health caused by poor care. The California Advocates for Nursing Home Reform have published a guide for preventing abuse in long-term care facilities. How does one increase the odds there will be no abuse or neglect?

1. Be very supportive of the transfer to a nursing home. Under most circumstances, the initial entrance to a nursing facility will engender feelings of loss or abandonment. Visit frequently to help with the adjustment.

2. Make the most of visits. Visit frequently, and at different times. Also visit during meal time. This will give you a more complete picture of care and the performance of staff.

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Elder abuse comes in a variety of forms. The abuse we hear about most frequently is physical abuse, which includes assault, battery, and sexual offenses, and financial abuse, which is usually a matter of fraud or undue influence upon a senior citizen. Both physical and financial abuse are very serous offenses that should be promptly reported to the police, and a private civil attorney.

Another, less discussed, form of abuse is abuse in the nursing home or assisted living setting. In California, there are approximately 100,000 nursing home beds, and probably an equal number of assisted living beds, and the health and well being inside these facilities usually depends on the quality of the care they are receiving. In truth, the word “abuse” is probably a bit misleading, as these occurrences are usually a matter of neglect of the elderly resident, not physical abuse.

Unfortunately, most instances of neglect or abuse are not reported. Elderly residents are often afraid to report an act of abuse or neglect for fear of retribution by staff, or simply because they cannot stand the thought of being transferred to a different facility. Or, more often, the decline in health caused by the neglect is attributed to some other cause, usually related to old age.

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