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The Marin Independent Journal reported in a recent article that Marin county health officials are administering free flu shots to nursing home employees. The article indicates that this action is in response to the results of a recent health survey indicating that vaccination rates for the residents of nursing facilities is high, but the employee vaccination rates are quite low.

This report should probably evoke a head scratch or two because of the simplicity of the study and solution. It makes no sense why the employees are not getting flu shots. Nursing home employees handle the residents’ food, medication, linens, utensils, garments, etc. The employees are in constant contact with the residents and their possessions; therefore, germs are almost certain to spread. It is surprising that it took a study to conclude that vaccinations need to be freely given to, if not required of, nursing home employees.

Public Health Officer, Dr. Matt Willis, stated that, “The elderly are our most vulnerable population when it comes to complications from influenza.” Elderly people often have weakened immune systems, so a case of the flu is potentially deadly.

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Assembly Bill 40 is a California law that took effect January 1, 2013. The bill is intended to expand reporting requirements related to elder abuse.

The Napa Valley Register reported in an article that the Napa County Health and Human Services department investigated 370 abuse and neglect cases in 2012. 295 of those involved seniors and the rest involved disabled adults. Reports of theft and embezzlement from the elderly have significantly increased over the last couple of years.

In light of this new bill, it is important to look at the increase in reported instances of abuse and neglect in different ways. A simplistic view of this increase indicates that elder abuse and neglect is on the rise. Whatever measures have been put in place to combat abuse over the last couple of years have failed.

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Gwen D. Hughes, a former California nursing home director, was sentenced on Wednesday to three years in state prison for inappropriately medicating patients at a Kern County nursing home. The San Francisco Chronicle reported that Hughes was originally charged in the deaths of three patients. Hughes however pleaded no contest in October to one felony count of elder abuse with a special allegation that the abuse contributed to the victim’s death, according to the article.

Hughes was working as nursing home director at Kern Valley Healthcare District’s facility in Lake Isabella at the time of the alleged crimes. California Department of Justice officials, including Attorney General Kamala D. Harris, allege that Hughes ordered the director of pharmacy to write doctor’s orders for psychotropic medication for 23 patients.

The prescriptions were not written for health or therapeutic reasons, but instead written to “keep them quiet” says the article. The Justice Officials allege that the psychotropic drugs were given to patients who were “noisy, prone to wandering, who complained about conditions or were argumentative” according to the article. This is clearly an example of nursing home abuse.

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According to the Orange County Register, local officials believe that a 28-year-old Riverside resident named David Moreno may have assaulted numerous victims while working as a maintenance worker at Emeritus Senior Living in Yorba Linda. Officials are asking if anyone has information regarding the matter, to please contact the Orange County District Attorney’s Office.

Moreno is already facing a felony sexual battery on an institutional victim charge and a felony sexual penetration by a foreign object of an incompetent victim charge. These acts allegedly occurred in June or July of 2012 when Moreno went into the room of a resident suffering from dementia.

Moreno plead guilty and is free on a $100,000 bail.

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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.

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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.

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Glendale attorney, Russ Balisok, alleges on behalf of his clients California Advocates for Nursing Home Reform, in a new lawsuit, that state regulators allow nursing home companies to siphon money away from patient care and send it to the wallets of the corporations that manage the facilities.

Current state law allows nursing homes to outsource their management to third party corporations. The company that owns the nursing facility can shop around different management companies and pay them a fee to control the day to day operations. The management company designates a portion of its pay towards managing the facility and another portion as a management fee. The management company also receives a portion of the revenues from the home(s) it operates. These agreements are state approved agreements.

Balisok argues that the percentage the management companies takes off the top deprives the nursing homes of vital revenue needed to ensure quality care and services for the patients. The management companies do not operate for the good of the patients, but instead collect money off the top of the revenues and run the nursing facilities for as low a cost as possible.

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An article in The Modesto Bee reported yesterday that Donna Darlene Palmer, former head nurse at a Placerville nursing home, will stand trial for felony elder abuse. Palmer and Rebecca Smith are the two nurses criminally charged by the California Attorney General for their involvement in the death of a 77-year-old Cameron Park woman. Palmer was the director of nursing at the time of the incident and Smith was one of her subordinates.

If you follow our Nursing Home Abuse and Neglect Blog, the name Johnnie Esco may sound familiar. Four and a half years ago, Johnnie Esco died at the age of 77 as a result of what her family and El Dorado County prosecutors believe was a case of elder abuse. Don Esco, Johnnie’s now deceased husband was a central figure in our previous blog. Mr. Esco pressed for criminal charges ever since his wife died in 2008.

Attorney General Kamala D. Harris recently announced plans to use three specialized teams comprised of healthcare professionals and investigators to increase its efforts to investigate and prosecute instances of criminal elder abuse in care facilities. Mr. Esco’s persistence over the last four years certainly played a role in bringing about more criminal investigations against nursing homes and their employees.

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The Mercury News recently reported that a former commander in the Pinole Police Department, and his wife, have been charged with trying to defraud an 82-year-old Pleasanton woman. Matthew Messier, the 36-year-old former police commander was charged with several crimes including four counts of elder abuse. Messier and his wife attempted to defraud the elderly woman by placing her entire estate into a trust under their control.

The victim’s assets were estimated to be between $750,000 and $1 million.

The investigation began in July while Messier was still police commander with the Pinole Police Department. Messier used his position as police commander to gain the victim’s trust. The victim then began depositing funds into a trust controlled by Messiers. Messier had been with the police department since 2001, but he resigned his position October 21 of this year.

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Families with loved ones in adult care facilities are pushing for new legislation that will affect how the facilities handle missing patient situations according to a recent article in the Mercury News. The legislation is not up for a vote yet, but if enacted, the law will require care facilities to contact authorities immediately once a resident is discovered missing or has failed to return at a scheduled time.

The two incidents highlighted in the article involve situations where mentally impaired adults went missing for several hours from the facilities whose care they were under. The facilities did not act quickly in either case.

Yolanda Membreno was an 86-year-old mentally impaired woman under the care of Julia’s Home. She went missing from the home on September 30th of this year. According to Roy Roberto, the man who operates Julia’s Home, their established protocol is to conduct their own search before contacting the police. In Membreno’s case, the staff followed protocol but that meant waiting an hour before contacting the police. Membreno was found dead on a playground only 100 yards away from the entrance to the care facility just a few hours after she went missing.

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