Articles Posted in Southern California Elder Abuse

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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

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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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Attorney Randy Walton was invited by the Intertribal Court of Southern California to speak on the issue of elder abuse and nursing home abuse and neglect. The event took place on June 15, 2011 and was hosted by the San Pasqual Band of Indians. Approximately 100 people attended.

The event was entitled Know Your Rights, Benefits & Laws, and was produced to benefit tribal elders and seniors from all the San Diego County Indian tribes. Topics included Identity Theft, Medicare, Elder Abuse, Health and Well Being, and Social Security Benefits, and included a variety of speakers.

Mr. Walton addressed the issue of abuse and neglect in the custodial care setting, including nursing homes and assisted living facilities, and advised what to do to avoid abuse and neglect, and what to do if it occurs.

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Prime Healthcare Services is a Southern California company well known for turning around troubled hospitals. It also happens to be the subject of a federal investigation for possible overbilling in relation to an outbreak of septicemia. Last week’s release of an investigation by the San Diego Union Tribune and California Watch brought more bad news to the hospital chain.

According to the investigation, eight of the top 10 hospitals for malnutrition rates are owned by Prime Healthcare Services. Why such high rates of malnutrition at these hospitals? It depends who you ask. Prime will tell you it’s because of the patient population they typically serve; very sick patients who generally do not have any health insurance or primary health coverage.

“We agree we’re going to be higher than others because we have a focus on malnutrition and because of our patient mix,” said Mike Sarrao, attorney for Prime. “Because of our business model without managed care contracts, we see more emergency room cases.”

Others suggest the high rates give the hospital a financial benefit. A diagnosis of malnutrition brings with it higher reimbursement rates from Medicare. Remarkably, in 2009, Prime reported that 25 percent of its Medicare patients had some level of malnutrition, while the state average was 7.5 percent.

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The Washington Post is out with an interesting article about a growing national trend – younger patients are ending up in nursing homes. According to the article, approximately one in seven nursing home residents in the United States is under the age of 65, a number that has grown significantly just in the last eight years. This development has raised all kinds of issues for the nursing homes that take these younger patients like Adam Martin, at 26-year-old quadriplegic who is living in a nursing home.

“It’s just a depressing place to live,” Martin says. “I’m stuck here. You don’t have no privacy at all. People die around you all the time. It starts to really get depressing because all you’re seeing is negative, negative, negative.”

Older residents have their own issues with it as well, and frequently complain about loud music and rowdy visitors. And while most nursing homes try to house younger residents together, new steps are being taken to address this growing problem.

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This is the time of year that families crisscross the country to see each other and celebrate the holidays, but it’s also a good time to check in older relatives who might be living alone, and under the care of someone. It is estimated that up to two million American seniors have been mistreated or abused by someone they rely on to provide car. For every case of elder abuse reported to Adult Protective Services, five cases go unreported.

Experts couldn’t agree more. Holiday visits, they say, offer a perfect opportunity to assess the needs and health of elderly relatives, whether they’re living independently or in a care facility. “You should visit with a checklist in your head,” says San Francisco social worker Mary Twomey. She advises people “to look for red flags: Has your parent lost weight, are they no longer interested in things they once enjoyed, are there any signs of physical abuse?”

Read more here from the LA Times here.

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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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