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Articles Posted in Legislation

The Sacramento Business Journal is out with an article accusing the State of California of exposing elderly nursing home residents to dangerous caregivers because state regulators have failed to implement a 2006 law that requires the creation of a centralized database for background checks on all long-term caregivers.

According to the article, an investigation by the state’s Senate Office of Oversight and Outcomes discovered at least 20 incidents where individuals who lost their certification as nursing assistance because of wrongdoing were cleared and hired in a different facility.

“There is no excuse for allowing people with known histories of abuse to work in residential care facilities for the elderly or as caregivers in any other setting,” said Michael Connors, an advocate with California Advocates for Nursing Home Reform, a non-profit that advocates on behalf of nursing home and residential care residents.

Nursing home abuse and neglect lawyers in California often lament the state’s weak enforcement of bad nursing homes. The California Department of Public Health, due primarily to inadequate funding, rarely provides the strong oversight of California’s 1,200 or so licensed skilled nursing facilities. As a result, bad nursing homes operate with relative impunity, and those who screw up rarely suffer the consequences.

Apparently California is not alone. In Connecticut, the director of the state’s Department of Public Health said his unit is dangerously understaffed. He has only four investigators to oversee the state’s 231 certified nursing facilities, and told the Norwich Bulletin that if he had 10 more, he would have a lot more cases.

State Sen. Edith Prague has apparently had enough. She is set to re-introduce a bill that would make it easier to hold the owners of nursing homes criminally responsible for abuse and neglect of patients in their facilities. Under Prague’s bill, the state’s DPH would be required to include a notice in nursing home applications telling owners they could be held criminally liable for patient neglect by employees, including for things such as inadequate staffing. “You can’t sue the state, but the nursing home owners who cut back on staffing I feel should be held responsible,” Prague said.

George Washington once said:

Discipline is the soul of an army. It makes small numbers formidable; procures success to the weak, and esteem to all.

Letter of Instructions to the Captains of the Virginia Regiments [July 29, 1759]. The advocates of consumer rights, viewing the resources of defense firms and corporate defendants, can relate to the trepidation felt by the out-numbered and out-gunned Continental Army. Because of that disparity in resources, Consumer Attorneys of California (“CAOC”) consolidates the voices of consumer attorneys throughout the state to (1) preserve and protect the constitutional right to trial by jury for all consumers, (2) champion the cause of those who deserve redress for injury to person or property, (3) encourage and promote changes to California law by legislative, initiative or court action, (4) oppose injustice in existing or contemplated legislation, (5) correct harsh, unjust and oppressive legislation or judicial decisions, (6) advance the common law and promote the public good through the civil justice system and concerted efforts to secure safe products, a safe workplace, a clean environment, and quality health care, (7) uphold the honor, integrity and dignity of the legal profession by encouraging mutual support and cooperation among members, (8) promote the highest standards of professional conduct, and (9) inspire excellence in advocacy. This post is a multi-blog effort to inform consumer attorneys about CAOC’s value and encourage participation in CAOC through membership.

As America’s elderly population continues to explode (it will double by 2030), an important question that has received little attention in the national healthcare debate is how the U.S. will be able to deal with 78 million aging baby boomers. Those of us who practice elder abuse and neglect law regularly see the costs associated with long term care, and let me tell you, it ain’t cheap.

For many nursing home residents the story goes like this: there is an event that causes them to be hospitalized, whether it’s an injury such as a fractured hip, or an illness. It is determined that after the hospitalization, nursing home rehabilitation is in order. The hospitalization and the first 100 days of nursing home care will generally be covered by Medicare. When the 100 days is up, and the person is determined to be too frail to return home, the financial obligation falls upon the resident, or his or her family. At $5,000 – $10,000 per month, this can quickly be financially devastating. If there is no money, or the resident’s spends it all in the first months of care, they are typically qualified for Medi-Cal, and the taxpayers foot the rest of the bill, even if the patient spends the next five years in the nursing home.

This article at NewAmericanMedia.org addresses this very question.

Starting yesterday, new California regulations will require finger printing and a criminal background check for all new in-home caregivers before the caregivers can get paid. The law, enacted to help prevent fraud and elder abuse, is not being well received by many providers.

Many counties have complained that the new mandate from the state has been poorly explained, and most are unprepared to implement it.

“We’ve been working with the counties since the budget passed to talk through these very significant changes. We understand that the timelines are very aggressive,” said Lizelda Lopez, spokeswoman for the state Department of Social Services. “But we must comply with the law.”

Governor Schwarzenegger has vetoed SB 303, a proposed law that would require doctors to inform residents about the dangers of psychotropic medications, and require nursing homes residents to give consent before such drugs can be given.

According to the California Advocates for Nursing Home Reform (CANHR), the use of psychoactive drugs has become an epidemic in California. According to one study, nearly 60% of all California nursing home patients are administered psychoactive narcotics, a huge increase from only a decade earlier.

Governor Schwarzenegger admitted that misuse of antipsychotic drugs is a serious problem in nursing homes when he vetoed the legislation, and even cited a study that found more than have of all residents on psychoactive drugs are in violation of federal guidelines.

A report being released today by the Government Accountability Office finds that the federal program designed to identify and scrutinize the country’s worse nursing homes is missing many of the poor performers. The Centers for Medical and Medicaid Services has identified about 136 nursing homes nationwide that are considered “special focus facilities” for their history of problems related to patient care, but many more questionable facilities are not making the list.

Herb Kohl, the chairman of the Senate Aging Committee wants more information about all of the poorest performing facilities on the government website Nursing Home Compare. The current report does not identify the homes.

“If far more than 136 nursing homes boast the bleakest conditions, then perhaps we should consider expanding” the program, said Kohl.

In the 10 years since I took my first case against a nursing home for elder abuse, I have seen a growing number of homes going without liability insurance. While the uninsured problem used to be confined to the small mom-and-pop assisted living facilities with 6 to 12 beds, now I am seeing in large, institutional-type skilled nursing facilities. On Friday, the Oakland Tribune did an excellent article on this problem.

The article profiles the story of 39-year-old Grover Brown, a multiple sclerosis and Parkinson’s patient with paraplegia. Brown was a resident of High Street Care Center in East Oakland. High Street is owned by Trinity Health Systems, whose president, Randal Kleis, has operated about a dozen facilities all over California under several corporate names.

While in the care of High Street, Brown developed a pressure ulcer on his coccyx, which, due to neglect, worsened to the point that doctors were required to remove his tailbone to curtail the deep infection. Brown and his family hired an elder abuse attorney, who sued High Street for abuse and neglect under California’s elder abuse laws, which also protect “dependent adults” like Brown.

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

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.

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