Articles Posted in Southern California Elder Abuse

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The unspoken problem with California nursing homes is staffing. Not enough of it, and poor training for those who do it. Who knows what caused this major screw up, but you can be sure it’s related to staffing. A 94-year-old resident of Silverwood Senior Living Facility, a skilled nursing facility, went missing last month. Staff searched everywhere for the dementia patient, but couldn’t find her.

Thankfully, someone thought to check the walk-in freezer in the nursing home kitchen. There they found the resident locked inside the freezer where the temperature was set at five degrees. Thankfully she was unharmed. Still no one knows just how she got in the freezer, and the home, who has a history of regulatory violations, self-reported the incident as required by law.

Mark Mostow, a VP for the nursing home, released this obligatory statement about the resident: “We immediately conducted an investigation, and took appropriate corrective action against two employees. It’s an unfortunate incident, and we’re very sorry that it happened, and we’ll do everything in our power to ensure this does not happen again.”

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It is being reported by California Watch that the U.S. Department of Justice is investigation what is being described as lax care at several California nursing homes, and even threatening criminal and civil actions against those homes. Specifically, the investigators will be examining the use of psychotropic drugs in these facilities and those injured by the misuse of such drugs. Also being investigated are the nursing homes that prematurely discharge patients whose condition requires them to stay.

The investigation was triggered in part by the federal health reform law that includes the Elder Justice Act. That act allows for the coordination between the U.S. attorney general’s office and local and state law enforcement to crack down on elder abuse and neglect. The Northern California office of the Justice Department retained the services of a consultant, who interviewed local ombudsmen’s offices about nursing home complaints. Out of those interviews, several facilities were identified.

U.S. Attorney Melinda Haag told California Watch that her office hired the consultant approximately two months ago, shortly after a California Watch article about the decline in the prosecution of elder abuse cases. “My office is in the process of evaluating the complaints our consultant gathered and will prosecute, to the fullest extent of the law, those individuals who are in violation of federal statutes,” Haag said in a written statement.

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The California Department of Public Health has levied its harshest fine against a nursing home after a resident fell from a mechanical lift. According to reports, the lift was being to transfer a 60-year-old patient from her wheelchair and into her bed. As nursing assistants were transferring the woman, the sling holding the woman broke, causing the woman to fall hard to the ground. She struck her head on a nearby door, causing a severe brain injury, and ultimately causing her death four days later.

Lift.jpg An investigation by the Department of Public Health revealed that the nursing home, the Eskaton Care Center, failed to properly maintain the lift. The lift, which law required be checked monthly, had not been checked for five years. The DPH report stated that the sling appeared worn and had “what appeared to be bleached out blood stains at the center.”

The nursing home can appeal the fine (and the AA citation it received), but it’s not clear if it will. “We’re mortified,” Trevor Hammond, the nursing home’s chief operating officer, told the Modesto Bee. “We had a tragedy when a piece of equipment failed. It was a catastrophe.”

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This story makes one wonder what would happen if a hidden camera sting was done in every nursing home. The attorney general of New York placed a hidden camera in a single room of a long-term care facility, which resulted in an indictment against nine nurses, the nursing home, for a whopping 169 separate crimes.

The indictment filed in the case alleges 57 instances of neglect during a three-month period in 2009. With the family’s permission, a hidden camera was placed in the room of a 53-year-old resident who suffers from multiple sclerosis and other mental and physical illnesses. The video revealed that the nurses failed, on several occasions, to turn the patient regularly as required, failed to medicate as needed, treat his pressure ulcers, or even change the resident’s clothing. Of course, in the medical chart, these nurses stated that all this care had been provided. The fraudulent medical charting resulted in further criminal charges.

In interesting footnote to the story, when the alleged abuse revealed, several people came to The Record newspaper to tell their stories of abuse or neglect inside the facility, including unanswered call lights and untreated infections and bed sores.

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stop-sign1.pngThe California Advocates for Nursing Home Reform (CANHR) has launched a comprehensive website that addresses the growing problem of drug misuse in California nursing homes. Every day, approximately 25,000 California nursing home patients are given an antipsychotic drug. Half of all dementia patients are administered these drugs despite FDA warnings these drugs can kill a dementia patient.

Because of this CANHR has launched a campaign to help end the drugging of California nursing home residents. CANHR states its goal this way:

The goal of the campaign is to stop nursing homes and doctors from misusing dangerous antipsychotic drugs and other types of psychoactive drugs to chemically restrain residents and to replace drugging with individualized care. Through education, advocacy and political action, we seek to bring Californians together to end this harmful practice.

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A resident of St. Edna skilled nursing facility in Santa Ana (a Covenant Care facility) was awarded $3.1 million by an Orange County after the jury found that the nursing home failed to recognize that the resident was overdosing on morphine. The jury also found that the nursing home acted with malice or oppression, and will award punitive damages at a hearing next Tuesday.

St. Edna’s was among the many California nursing homes who received $880 million in Medi-Cal compensation from the state in a program that began in 2004, and was designed to promote care and avoid staffing deficiencies. Many homes that received the additional money still reduced staffing, despite profiting from the additional funds. Apparently St. Ednas was one of those homes.

In this case, Barbara Lefforge was admitted to St. Edna on Sept. 17, 2007, to rehabilitate from tendon repair surgery. Her surgeon mistakenly recommended 50 mg of morphine for pain instead of 50 mg of Demerol. That is a huge dose of morphine, which Lefforge’s attorney argued should have been promptly caught by the nursing home staff. According to reports, a nurse at the facility could not get the full does, so took 30 mg from an office emergency kit and gave it to Lefforge, who suffered an overdose, which itself went unnoticed by the staff. She suffered a major brain injury.

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The family of a man who was found dead in a ditch near a freeway overpass is blaming a Long Beach hospital for his death. Joseph Castillo, 63, had apparently been dead for several days when his body was found near the 405 Freeway near the 710 Freeway off-ramp.

According to family, Castillo suffered from advanced cancer, dementia, and diabetes, and had a trachea tube in his throat when he was released from Pacific Hospital in Long Beach at 2:00 a.m. on the 4th of July. He had been taken there when he collapsed at home the day before. After spending several hours in the hospital, he was released from the hospital, where it appears he just walked away.

When Castillo didn’t return home, the hospital called the police to report him missing. Castillo’s daughter said her family was unaware that her father was going to be released from the hospital, and expected that she, or someone else from her family, would have received a call to take the dementia suffering Castillo home. She believes her father was released prematurely because he was a Medi-Cal patient, and that he would be alive today had the family been contacted.

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Over the last six years, complaints against Ventura County nursing homes are up almost twentyfold despite a California law that pumped nearly $900 million of Medi-Cal money into nursing homes throughout California. Remarkably, just prior to receiving the additional funds, Ventura County ombudsmen filed only 10 complaints against local nursing facilities, yet over a the period of July 2009 to May 2010 the same ombudsmen filed 194 complaints.

“The numbers show that (the law) did not do what it was supposed to do: increase the quality of care for residents in nursing homes,” Sylvia Taylor Stein, executive director of the Long Term Care Services of Ventura County ombudsman program, told the Ventura County Star. “They were given a checkbook with no oversight.”

By way of example, Oxnard’s Shoreline Care Center received $877,356.00 in additional Medi-Cal funding from 2004 to 2008, but records show that the facility actually provided less nursing hours per patient per day than it did prior to the funding increase. It’s not surprising that the nursing home took in $4.1 million in profits after the law was passed.

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In an ongoing investigation, journalists Tracy Weber and Charles Ornstein of ProPublica have a startling article out that says that more than 3,500 registered nurses with “clean” nursing licenses from the State of California have been punished for misconduct in other states. According to the article, approximately 2,000 of these nurses will now face discipline in California.

The article states that California officials won’t disclose the names of nurses who were discovered to have disciplinary records until charges are filed, but will be filing emergency petitions with the board for nurses who are viewed as a threat to public safety.

Weber and Ornstein easily uncovered cases involving current California nurses. Here’s a sampling:

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SmartMoney.com has an article out entitled 10 Things Nursing Homes Won’t Tell You. Which has been adapted from the book “1,001 Things They Won’t Tell You: An Insider’s Guide to Spending, Saving, and Living Wisely,” by Jonathan Dahl.

Walton Law Firm thought you might like to see the list:

1. “We’re careless about the drugs we give out.”

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