Southern California Nursing Home Abuse Lawyer Blog

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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