Articles Posted in San Diego Nursing Home

Cutting costs was the state’s goal in eliminating the Adult Day Health Care (ADHC) system last year. That goal does not appear to have been met, according to a recent article in California Healthline. Instead the program that stemmed from a lawsuit challenging California’s proposal to eliminate the ADHC program, the Community-Based Adult Services program, will cost nearly as much as the old program, yet will provide services to fewer Californians.

In the 1970s, California created the ADHC system to provide health and social services to the elderly and disabled. The system was a response, at least in part, to the many horrific stories of California nursing home abuse and neglect. In the face of public outcry and outrage, elimination of ADHC due to budgetary limitations quickly gave way to a scheme to restructure the program.

The restructured program, however, will cost almost as much as ADHC, but will provide services to only 80% of previous ADHC beneficiaries (previously ADHC served approximately 55,000 seniors and disabled persons annually). The original budget for ADHC was $170 million. The current budget for the replacement program, Community-Based Adult Services (CBAS), is $155 million, according to Lydia Missaelides, executive director of the California Association of Adult Day Services. But those numbers do not even take into consideration the costs of the legal and legislative battles over the programs or the amount of time, money, and effort it will take to get CBAS up and running. Thus, by some accounts, the revamping of ADHC has been, in large part, a failure.

Self-neglect often can be a sign of San Diego elder abuse or neglect. Self-neglect typically occurs when adults cannot or do not take care of themselves properly, according to a recent article in the San Diego Union-Tribune, but it also may indicate a caretaker’s negligence. Generally unsanitary conditions of residents or of a California nursing home or assisted living facility should not be tolerated. Under California law, all nursing home residents are entitled to a safe, clean, and comfortable home-like environment, and friends and family members of elderly residents should make sure facilities are keeping up their hygienic standards.

Sometimes it can be difficult to believe that an elderly loved one is not taking care of himself or herself. Signs of self-neglect may include not eating or drinking, failing to buy food, missing doses of medication or taking too much, not going to the doctor, and refusing or forgetting to bath or dress. Self-neglect can put vulnerable seniors at risk of serious injury or illness, including hospitalization. According to the San Diego Union-Tribune, research shows that the risk of self-neglect increases when an older individual has cognitive impairments or mental health problems, chronic health problems, uses alcohol, lives alone, or has fewer perceived or actual financial or social resources.

Our San Diego elder abuse attorneys know some of these examples also can be signs of depression, which can occur when an elder is being neglected or abused by a caretaker. It is crucial for family members to be on the lookout for these signs and to visit nursing facilities prior to admitting seniors, as well as to make regular visits once a loved one is residing at a facility. Remember, you have the right to ask staff members questions about a facility’s policies or cleanliness and to voice any concerns.

Last week, the federal government issued a new report that scrutinizes California nursing home inspections. The report finds those inspections lacking because inspectors fall far short in following up on their own investigative findings into problems at nursing facilities across the state. The California Department of Public Health is responsible for inspecting the state’s 1,150 nursing homes. Our San Diego County nursing home abuse lawyers have successfully sued nursing homes and residential facilities for neglect and abuse for years, and our firm is recognized as a leader in this area of law. As a result, we are familiar with how important it is for state officials to conduct thorough and accurate nursing home inspections.

The Department of Public Health (DPH) enforces both state and federal regulations that govern California nursing homes. However, the state and federal systems follow different rules and can levy different fines and sanctions when nursing homes commit violations. According to the DPH, it receives about 19,000 complaints and facility-reported issues each year. The DPH instructs inspectors to first examine problems in light of state laws that allow them to levy fines of $1,000 to $100,000. Those fines can be levied for a number of reasons, including, for example, a finding of San Diego elder neglect or abuse.

The recent federal report examines how well state inspectors from the DPH enforce federal regulations. When state inspectors fail to follow up on their inquiries, it can potentially enable sustained neglect or lax practices that can injure residents, according to a report from California Watch. The federal report, which was issued by the Department of Health and Human Services’ Office of Inspector General, examined the handling of 178 findings of deficiencies at three nursing homes that send a high rate of patients to nearby hospitals with painful bedsores and severe infections. The inspector general found that nursing home regulators underestimated the severity of problems in 13% of the findings.

A state investigation conducted by health officials has uncovered a widespread problem in California nursing homes, reports a recent article in The New York Times. Officials found that pharmacists responsible for reviewing the medication of California nursing home patients routinely allowed inappropriate and potentially deadly prescriptions of antipsychotic medications. The California Department of Public Health (CDPH) found that in 18 out of 32 investigations between May 2010 and June 2011 pharmacists failed to note cases in which elderly patients were inappropriately given powerful antipsychotic drugs.

In one instance, an elderly woman with a history of seizures was prescribed Seroquel, a strong antipsychotic drug (often used to treat schizophrenia), even though research shows that seniors who take antipsychotic drugs are more likely to experience seizures. She was also prescribed Trazodone, an antidepressant that has been linked to an increase in seizures in elderly people, as well as a second antipsychotic drug called Risperdal. Such a combination is potentially lethal, according to state investigators, because they can cause life-threatening heart arrhythmias. Our San Diego nursing home abuse lawyer knows it is essential for caretakers and doctors to be aware of the ways in which certain medications can impact elderly patients. Otherwise, dangerous side effects may occur, or medications that likely should not be combined with other drugs may be prescribed by mistake.

Under California nursing home abuse law, consulting pharmacists who work for nursing homes must review patients’ charts monthly. They then make recommendations to treating physicians about whether medications should be ceased, reduced, or changed, if they pose potential hazards or are causing harmful side effects. The CDPH discovered that California pharmacists failed to identify the misuse of antipsychotic medications in 90% of cases. The CDPH also found a “probable correlation” between faulty druggist reviews and the amount paid to pharmacists: in 59% of the cases involving defective reviews, nursing facilities had been cited for accepting pharmacy services below cost. The average pay rate for pharmacists in California is approximately $56 per hour, but instances were uncovered where pharmacists were paid as little as approximately $23, $16, or $11 per hour.