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Making the decision to place a loved one in a nursing home is always a difficult and emotional process. The San Diego nursing home neglect lawyer at our firm appreciate that the process is made even more difficult by the fact that most families do not know where to begin when choosing a home. With stories of nursing home mistreatment shared frequently, it is not easy to confidently select a facility where a loved one’s quality of care will be prioritized.

There are no fool-proof ways to chose a long-term care facility without having any risk at all of a senior suffering from neglect or mistreatment. However, one great resource to start with is the “Nursing Home Compare” website supported by the Centers for Medicare and Medicaid (CMS). The website offers various tools which allow those throughout the country to get an idea of how certain nursing home stack up against one another on a wide range of variables. Combining various data sets (mostly based on federal regulatory information), the website also gives virtually all nursing homes in the country a uniform rating of between one and five stars. The rating is perhaps the easiest way to get a split-second estimate of the level of care likely to be provided at any given facility.

This week the Government Accountability Office (GAO) released the results of a study into the CMS rating system. The study was called for by the Patient Protection & Affordable Care Act. The research examined the history of the nursing home rating system and the ways that the system might be altered in the future.

The American Academy of Neurology’s most recent position statement on abuse and violence recommends that neurologists screen patients for abusive treatment as part of their regular routine. As our North County elder abuse lawyers know, seniors are at serious risk of being mistreated or abused. Unfortunately, abusers often turn out to be the people we expect to be able to trust the most, including nurses, group home staff, and other caretakers.

California elder abuse law prohibits commonly known types of abuse—such as physical or sexual abuse—as well as the negligent failure of caretakers to exercise reasonable caution in the care or custody of an elderly person. That includes providing proper care for a senior’s medical and mental health needs and protecting elders from health and safety hazards. The American Academy of Neurology’s position statement defines elder abuse as abuse or neglect of a person 65 years or older, or of an individual who is physically or mentally disabled.

According to the American Academy of Neurology, the American Medical Association encouraged physicians in 2008 to ask patients about family violence histories on a regular basis because such information is crucial to effective diagnosis and care. Failure to do so can lead to further physical or emotional harm and treatment failure. The authors of the position statement, Elliott A. Shulman, M.D., and Anna DePold Hohler, M.D., state that identification of a patient’s abuse history, if any, is important because it can influence the assessment and treatment of presenting health concerns.

Only 1 out of 7 errors at hospitals are recognized and reported, according to a new report released by the federal government. A New York Times article reports that federal investigators scrutinized errors, accidents, and other events that harm Medicare patients while they are hospitalized. Our San Diego elder abuse lawyer knows that entrusting a family member to a hospital’s care sometimes can be scary, especially if invasive procedures such as surgery are necessary. Unfortunately, there are a number of problems that can occur when a loved one is hospitalized. For example, painful bedsores can occur when a patient lies in the same position for long periods of time without being rotated by a nurse. Patients who need extra attention are at a serious risk of falling and injuring themselves if left unsupervised. Serious infections can also set in, and a delay in treatment could mean the difference between life and death for an elderly loved one.

Our San Diego elder abuse attorney knows that incident reporting systems ensure that hospitals hold their doctors and other staff members responsible for adverse events. According to the New York Times, an adverse event is any significant harm a patient experiences as a result of medical care. In order to qualify for payment under Medicare, hospitals must keep track of medical errors and adverse patient events. They must then analyze the causes of those errors and make efforts to improve their care.

However, the government report notes that even when hospitals investigate preventable injuries and infections reported by staff, they rarely alter their practices to stop the repetition of such adverse events. Daniel Levinson, inspector general of the Department of Health and Human Services, stated the investigation uncovered that some of the most serious problems, including those that caused a patient’s death, were never reported. Independent doctors reviewed patient records in order to uncover unreported events. According to Mr. Levinson, more than 130,000 Medicare beneficiaries experienced one or more adverse events in hospitals in a single month.

America’s largest for-profit nursing homes deliver significantly lower quality of care, according to a new study conducted by the University of California San Francisco (UCSF). The UCSF-led analysis of quality of care at nursing homes around the country is the first-ever study focusing solely on staffing and quality at the 10 largest for-profit chains.

The reason for lower quality of care at large for-profit nursing homes, the study reports, is that such facilities usually have fewer staff nurses than non-profit and government-owned nursing homes. Our San Diego nursing home abuse lawyers know that lower staff numbers typically mean less one-on-one care and personalized attention. It can also mean that when such homes are short-staffed, important tasks may be rushed or paperwork may be missed.

The study, which will be published in Health Services Research, found that poor quality of care is prevalent at many nursing homes. However, the worst offenders are the largest for-profit chains because that is where the most serious problems generally occur.

According to one author, Charlene Harrington, RN, PhD, the top 10 nursing home chains employ a strategy that fails to make quality care a priority. They keep labor costs low in order to increase profits. Importantly, low nurse staffing levels are considered the strongest predictor of poor nursing home quality. Poor nursing home care can lead to California elder abuse or neglect, such as lack of supervision, painful bed sores, or infections. Large nursing home chains keep costs low by reducing staff, particularly RN staff.
The top 10 largest for-profit chains control approximately 13% of the nation’s nursing home beds. This is particularly concerning since California’s adult care budget repeatedly has been slashed and more and more families are being forced to institutionalize their elderly loved ones due to a lack of services in the community.

The study reports that the 10 largest for-profit chains in 2008 were HCR Manor Care, Golden Living, Life Care Centers of America, Kindred Healthcare, Genesis HealthCare Corporation, Sun Health Care Group, Inc., SavaSeniorCare LLC, Extendicare Health Services, Inc., National Health Care Corporation, and Skilled HealthCare, LLC.

If you’re wondering why a study such as this one is so important, attorneys practicing in this area know that the 10 largest for-profit chains were cited for higher percentages of deficiencies, as well as higher percentages of serious deficiencies, than the best facilities. Additionally, the 10 largest for-profit chains in 2008 had the sickest residents, yet had total nursing hours that were 30% lower than non-profit and government nursing homes.

The UCSF study recommended “greater accountability and quality oversight mechanisms” because they would “help improve nursing home care, along with effective funding incentives and sanctions for low staffing and poor quality.”

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Less than one month after a convicted sex offender was committed to a nursing home, he began sexually assaulting fellow residents. According to a report in the Des Moines Register, state officials claim that medical experts did not consider 83-year-old William Cubbage to be sexual predator when they recommended moving him to the Pomeroy Care Center.

Yet since he moved into the nursing home facility, Cubbage—who previously had been convicted of sexual assault against both child and adult victims, including several young family members—has been accused of at least three separate sexual assaults involving different victims.

Our San Diego elder abuse lawyers know that sexual abuse can cause life-long trauma for victims and their families. In this case, it is particularly troubling that a convicted sex offender who still showed signs of sexual aggressive was placed in a facility where he could easily prey on vulnerable residents. Cubbage was committed to the nursing home by a judge against the advice of two state psychological examiners.

Southern California elder abuse occurs with surprising frequency, affecting thousands of area seniors. Unfortunately, in many ways it remains a hidden problem because most cases of elder abuse and neglect are never reported and wrongdoers are rarely held accountable for their conduct. This sad reality was brought home in an SF Weekly post on Monday which explained how fewer than one in one hundred cases of elder abuse ever result in a criminal conviction.

A comprehensive report conducted by the area police department uncovered the infrequency of punishments for elder abusers. The data mirrors similar research by state agencies which also highlighted the infrequency with which this conduct is ever brought to light. For example, the state’s Department on the Status of Women found that only one in five cases of California elder neglect are even reported to authorities.

Elder care advocates explain that many seniors do not report mistreatment because of what they call the “fatigue factor”—where seniors are reluctant to engage in a legal battle following poor care. In the nursing home context, unfamiliarity with their rights is also a factor in the underreporting of neglect. Many vulnerable residents of long-term care facilities are unaware of the level of care to which they should be entitled. Therefore, if a nursing home employee fails to provide them with the assistance they need many seniors are unlikely to share the situation with concerned friends or family members. Similarly, most nursing home residents are not familiar with more nuanced forms of nursing home neglect, such as the failure to properly supervise residents or allowing resident-on-resident attacks.

USA Today has analyzed nursing home rankings under Medicare criteria and found that lowest scoring nursing homes tend to stay that way, year after year. Sadly, many of these poor performing nursing homes are the only nursing facilities for miles.

According to this article, twenty percent of the country’s 15,700 nursing homes receive consistently poor ratings for the care they provide. With over 250,000 Americans living in skilled nursing facilities, that represents a huge number of vulnerable nursing home patients who are exposed to abuse or neglect every day.

“We want to see improvements, but we don’t expect a nursing home will jump to a five-star rating within a one-year time period,” said Medicare’s Thomas Hamilton.

Elder abuse or neglect in the nursing home is a fear many elderly Americans face. A case unfolding in Illinois is about as bad as it gets.

According to a report from the states Department of Public Health, several suspicious deaths at the Lake of the Hills nursing home may have been the result of a nurse deliberately overdosing troublesome patients. A year-long investigation into the deaths revealed that nurse Marty Himebaugh boasted to coworkers that she gave patients she felt were difficult or had “lived long enough” a drug cocktail that contained morphine sulfate, now suspected as the cause of several deaths.

I one particularly horrible finding, the nurse was reported as telling a coworker that, “those people aren’t meant to live that long,” referring to an adult resident who suffered from Downs syndrome, “they are meant to die in their teens and I’m going to help him along.”