Articles Posted in Southern California Elder Abuse

Do you have an elderly parent or loved one in a Southern California nursing home? A recent study of nursing facilities within our state found that in 20 out of 22 facilities tested, the drug-resistant and often deadly skin infection “MRSA was present. San Diego’s local ABC 10 News referred to it as a “superbug,” and warned that it is “rampant in nursing homes.” MRSA can be scary—it moves quickly, it’s highly contagious, and it can seriously affect elderly residents.

Until recently, researchers tended to focus on the spread of MRSA in hospitals, often neglecting to track the infection in nursing-home settings.

What is MRSA and what does its presence mean for nursing homes in California? Keep reading to learn more about this infection that is resistant to many “common antibiotics” used in nursing facilities.

One of the rights addressed in the Nursing Home Residents’ Bill of Rights relates to the Quality of Life in the nursing home. An individual’s quality of life should not be diminished because he or she resides in a nursing home. Now, an individual’s opportunities to engage in all of the typical social activities in the community might decline because of health related issues, but the individual must still be permitted to engage in activities within the nursing home and community that he or she is medically and financially able to engage in.xmasinnursinghome.jpg

There are a couple of specific clauses addressing the quality of life in nursing home:

A resident must be allowed to choose and participate in activities that he or she likes provided that the activities are part of his or her plan of care. (HSC 1599.1(d): 42CFR 483.15(b)(1). Clearly the nursing home medical staff will have a say in which activities a resident participates in especially if the activities involve physical activity. The nursing home has a duty to care for the residents and ensure their safety so there is some limitation on activities. However, residents cannot be forced to engage in activities that they do not wish to engage in.

A resident of a nursing home is no different than any other citizen in the United States when it comes to his or her rights and protections. Living in a nursing facility does not mean you give up your rights despite the new and oftentimes more controlled environment, as opposed to living independently. Each nursing home must inform residents of their rights and provide a written description of those legal rights. They must do so in a manner or language that the resident comprehends. Residents must be given the written description of their rights prior to admission and must acknowledge in writing that they received them.

Money is a topic addressed in a patient’s rights. According to the Federal Government, residents have the right to manage their own money or to choose someone to do if for them.

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This is straightforward, but as with anything that involves money it can get complicated. Residents can deposit funds with the nursing home and ask that the nursing home hold the funds for them. Before doing so, the resident must sign a written statement authorizing the nursing home to hold the funds. A resident may also ask that the nursing home manage and account for personal funds, but the written authorization is again needed here. The nursing home must give the resident access to any bank accounts or funds that it is holding for the resident. Residents may take advantage of this service, but they are not required to deposit personal funds with the nursing home.

In a recent article in the San Francisco Chronicle, Dr. Edgar Pierluissi brings to light an issue that many people are unaware of. It is an interesting “paradox” as Pierluissi puts it that seniors can be in no better place than a hospital for identifying, treating and monitoring illnesses, but that hospitalization “accounts for about half of all new-onset disability and worsening of existing physical disability in people older than 70.” The onset of disability or worsening of existing conditions is called “Hospitalization-Associated Disability.” <img alt="elderinhospital.jpeg" src="/files/2014/02/elderinhospital.jpeg" width="275" height="183" align="left" hspace="10" vspace="10" /

Causes of Hospitalization-Associated Disability

Elderly patients encounter numerous hazards during hospitalization.There are physical hazards such as bed or pressure sores, adverse drug reactions, and bowel or bladder dysfunction. Psychological hazards include confusion and depression. These hazards alone or combined can contribute to new or increased disability and a loss of independence according to Pierlussi. Doctors, patients, and relatives fear that an individual enters the hospital for treatment of an illness, but leaves disabled and no longer able to live alone.

The Sacramento Business Journal reported today on a new website that the California Department of Insurance launched in order to help educate California seniors. The article highlights a few aspects of the new site called “Senior Gateway”, but once you visit the site, you see that it has a lot to offer to not only seniors, but their families, caregivers and representatives as well.

Here are a few bullet points outlined by the Sacramento Business Journal for what “Senior Gateway” offers:

*Avoiding and reporting abuse and neglect by in-home caregivers or in facilities

A vast majority of the public has little if any knowledge regarding whether or not he or she has a claim for damages in the event of an accident. Often, the mentality of injured individuals is simply, “I’m hurt. I want money. Now who can I go after?” The key term that is thrown around a lot, but is not always completely understood, is negligence. The concept of negligence is the key to a claim for damages if you or someone you love is injured in a nursing home. Negligence is based on the theory that individuals in society must act in a specific responsible manner to ensure that lack of care does not negatively impact the society around them. The elements of a claim for negligence are first nature for attorneys, but are helpful to know for other individuals as well. Knowing these elements will not only help clarify a situation in which you think you might have a claim, but it will also enlighten you as to your own actions and responsibilities in daily life, both at work and at home. The elements that must be present in a claim for damages based on negligence are Duty, Breach, Causation, and Damages.

nurse.jpegDuty

Everyone has certain duties or responsibilities built into their daily lives. You can have a duty to act a certain way or a duty to not act a certain way. The staff members at a nursing home have a duty to care for the individuals living at the facility. There are certain actions they must take to care for the patients such as checking for bed sores and making sure medications are administered. On the other hand, they are not to engage in abusive behavior or neglectful practices. Certain individuals such as healthcare providers have heightened levels of responsibility due to their profession.

The recent sentencing of a former nursing home administrator from a Lake Isabella facility is sure to send shockwaves throughout the nursing home community. Channel 17 KGET news recently reported that Pamela Ott, a former nursing home administrator, was sentenced to three years probation and 300 hours of community service for the actions committed by lower ranking staff while under her watch and her subsequent lack of action to prevent further crimes. The news station reported that this is the first time in the country that an administrator was held criminally responsible for the administration of pyschotropic medications.

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The facts of the case paint Ott not as someone committing criminal acts, but instead as someone who failed to respond to criminal actions. Because of Ott’s failure to act, eight residents of the home were seriously injured and three of those died. From August 2006 to August 2007, these eight residents were inappropriately medicated by lower ranking staff in order to keep them quiet and subdued. Ott failed to monitor the medicating practices of the staff and then later failed to investigate these incidents after they were reported to her. She received complaints about nursing director Gwen Hughes’ abusive actions at the home, but ignored those complaints and instructed the employees to follow the director’s instructions. Ott was told by staff members that residents were being “forcefully restrained and injected with medications” according to The Bakersfield Californian, but she failed to do anything about it. Ott plead no contest to a felony count of conspiracy to commit an act injurious to public health according to the report. Ott’s plea deal resulted in three years probation and 300 hours of community service. If she had fought the charges and had been convicted on all counts, she could have faced 20 years or more in prison.

Our San Diego Elder Law Attorneys point to this regretful situation as additional evidence that both residents of nursing homes and their family and friends need to keep a careful watch over the conditions within nursing homes and the actions of the staff. In this instance, employees of the nursing home were using abusive tactics involving restraints and medication in order to subdue and control the residents. The evidence presented showed that this behavior was reported, but the nursing home administrator failed to handle the complaints appropriately, leading to additional instances of abuse and the resulting mistreatment of the side effects of the abuse. Three residents died. Our Southern California nursing home abuse lawyers agree with the prosecution in making a resounding statement that this type of behavior should not go unpunished.

Powerful antipsychotic drugs are frequently used in San Diego County nursing homes to address behavioral issues caused by dementia or Alzheimer’s disease, including aggression, agitation, and delirium. However, these drugs can have serious consequences for elders and can easily be misused or incorrectly prescribed. According to the Consumer Voice, when antipsychotic drugs are prescribed for elderly persons with dementia, serious medical complications can occur such as loss of independence, over-sedation, confusion, falls, and even death. Recently, nursing home advocates and those of us working in North County elder abuse law have been concerned about the misuse of antipsychotic drugs in nursing homes and residential facilities. Finally, however, the government is taking notice, and a federal agency has announced a new initiative to address this so-called “drugging epidemic.” pills.jpg

According to an elder care statement released by the Consumer Voice, the federal campaign has been launched in order to bring about the end of the use of antipsychotic drugs as chemical restraints for seniors. Unfortunately, some nursing homes in the San Diego area and across the nation improperly use strong antipsychotic medications to control elderly residents by effectively drugging them into submission.

Last year, the U.S. Department of Health and Human Services Office of Inspector General reported that the overwhelming majority of Medicare claims for antipsychotic drug were inappropriate. Michael Connors, Long-Term Care Advocate with California Advocates for Nursing Home Reform, stated that “[t]oo many nursing homes use antipsychotic drugs as a way to control residents when they don’t have enough well-trained staff who know their residents well and can give them the time and attention they need.” Additionally, many facilities fail to obtain the proper consent from residents or their families. Another elder care advocate asserted that chemical restraints are just as dangerous for residents as physical restraints, which frequently are a sign of abuse.

The San Diego nursing home neglect lawyers at the Walton Firm have learned about another appalling case of elder abuse and neglect. A San Diego woman is accused of elder abuse of a 93-year-old WWII veteran. The woman, 62-year-old Milagros Angeles, allegedly stole money from the victim and also failed to provide adequate care for him. The abuse came to light when bank employees became suspicious after the victim, Arnold “Max” Bauer, stopped coming in to do his banking. Investigators from Adult Protective Services checked on the elderly man and found him living in squalid conditions.

Elder abuse can often be hard to detect and is usually underreported. It can include falls or fractures, malnutrition, bed sores, infections, and poor maintenance of facility conditions.

In addition to California elder abuse, the victim’s caretaker in this case was charged with false imprisonment, theft by a caretaker, and possession of altered checks. According to reports by 10news.com, the victim’s home was littered with trash and rat feces. Dirty dishes and rotten food covered the kitchen counters. The caretaker allegedly lied to the elderly man’s family, telling them that he was fine and eating well. war%20veteran.jpg

Iris Ramirez owns four residential care facilities for the elderly in San Diego called Ambassador Senior Retreat. Those facilities, like all licensed RCFE facilities in California, are overseen by the California Department of Social Services – Community Care Licensing (CCL). That means licenses can only be issued by CCL, inspections are made by CCL, and in the event of a complaint, investigations are performed by CCL. In short, CCL is the regulatory agency that gives residents of these facilities (and their families) the assurance that laws will be followed, regulations enforced, and that proper care will be provided.

Ramirez apparently didn’t want to take any chances with CCL investigators, and, according to news accounts, offered bribes to the very people charged with overseeing her assisted living facilities. The investigators have been identified as Conchita Valero, Lydia Williams and Christina Nepomuceno.

A search warrant executed this month alleges that Ramirez purchased airline tickets for Valero and Williams to travel to the Philippines for a vacation, and also gave Valero cash in the sum of $2,800. In exchange for the tickets and the cash, the CCL employees fast-tracked Ramirez’s licenses to operate her facilities. Apparently you don’t need brains to operate a residential care facility. According to the news accounts, Ramirez told investigators that she was “probably” getting preferential treatment because of the bribes.

In addition to Ramirez, the investigation has focused on Selma Teer, the owner of the Eternal Sunshine Care assisted living facility on Quince Street in San Diego. According to court documents, Teer wanted to open another facility, and offered investigator Nepomuceno a $3,000.00 bribe to expedite the process. Like Ramirez, Teer made no effort to conceal her expectation of a quid-pro-quo. When Nepomuceno went on medical leave and did not return Teer’s calls, Teer left her a rather incriminating message on Nepomuceno’s state-issued cell phone:

“(You are) not returning my call. You are not paying my money back. You want a bribe for my application for my license. You lied. You are such a liar. You want a bribe, do your job. You don’t do your job; you give me my money back.”

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