Articles Posted in Southern California Elder Abuse

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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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.

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.

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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