DO YOU SUSPECT ABUSE OR NEGLECT? Contact Us for a Free Consultation

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Unfortunately, every day brings new stories about horrific instances of elder abuse and mistreatment. While any form of elder abuse is unacceptable, our San Diego nursing home abuse attorneys know that many instances of abuse or neglect may go undetected because they may not seem to be obviously caused by mistreatment. For example, our lawyers recently explained the important connection between nurse staffing ratios, quality of care at long-term nursing facilities, and elder abuse. It is tragic when one’s loved ones are harmed when the people entrusted with their care fail to adhere to the standard of care.

Under California elder abuse law, caregivers must provide the degree of care that a reasonable person in a similar position would exercise. This includes providing medical care appropriate for a senior’s physical and mental health needs. It also includes protecting elders from health and safety hazards. Skilled nursing home facilities typically have written care plans or nursing care protocols they must follow in order to ensure they are complying with the standard of care. The failure to follow a care plan can lead to serious injury or death, and can be the basis of a San Diego elder neglect lawsuit. wheelchair%202.jpg

Sadly, not all nursing home workers follow the protocols established to ensure the safety of their patients. According to Wood TV, a family is suing a nursing home facility over the death of their mother. The elderly woman died when her tracheostomy tube got caught around a bed rail and became dislodged. A tracheostomy tube provides an air passage to help a person when the usual route for breathing is obstructed or impaired in some way. Because of her size, the woman was supposed to have the help of two nursing home assistants to ensure that her tracheostomy tube did not dislodge. However, when the accident occurred only one assistant was helping the woman.

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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. elder%20hands%20x%202.jpg

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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Our San Diego nursing home abuse lawyers know that the holidays are a great time to check in on loved ones, including seniors. It can be easy to get caught up in the holiday hustle and bustle, but a simple phone call to your loved ones to let them know you are thinking about them can go a long way. The holidays can also be a good time to check on the medical care your loved ones are receiving and to make sure they do not have any concerns about their finances.

Unfortunately, the holidays are also a time when unscrupulous scammers target senior citizens. A recent news article in the Mission Times Courier describes several common scams that often target elders. California elder financial abuse is a growing concern across the state, as well as across the nation. The article provides several examples offered by the San Diego Police Department of the kinds of schemes to which seniors are particularly vulnerable.

The Grandparent Scam

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elder%20%20fade.jpgOur San Diego nursing home abuse lawyers know that neglect in assisted living facilities is a serious form of elder abuse. When those responsible for caring for our elderly fail to provide adequate care or violate health or safety standards, they must be held accountable.

Recently, a Michigan nursing home was investigated because maggots were discovered on a female patient. According to an article on AnnArbor.com, staff members at the home told a state inspector they had observed flies on or near the woman approximately two weeks before the maggots were discovered. The maggots were originally discovered because the 66-year-old woman had a catheter for a unitary tract infection. An incident report created by the nursing home stated that the woman was offered a shower when the maggots were found. According to the report, the woman refused the shower, so she was immediately given a bed bath by staff.

However, interviews with a state inspector provide a somewhat different version of events. During those interviews, staff members stated that the woman did not receive a shower because the nursing home did not have enough staff. One aide reported being instructed to document that the woman refused showers. A nurse manager also stated that she was instructed to report the discovery of maggots on the incident report as debridement, which is the medical removal of dead, damaged, or infected tissue. Doing so can increase the potential that the remaining healthy tissue will heal. The nurse manager reported that she was not allowed to put down “maggots” on the incident report.

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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. elder_abuse%20%284%20hands%29.jpg

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Last summer, our San Diego elder abuse attorney explained that state budget cuts threatened to do away with California’s Adult Day Health Care (ADHC) system. The system was established in the 1970s, partially as a response to stories of nursing home abuse or neglect. According to a report in the San Jose Mercury News, the cuts that many seniors, their caretakers, and elder advocates have feared for months will take effect on December 1, 2011.

wheelchair.jpgThe cuts will eliminate funding for day programs for thousands of seniors and the disabled. Some relatives fear that they now will have to institutionalize their loved ones. Others worry that they will have to quit their jobs or reduce their workload in a job market that is not tolerant of the need for flexibility. At the same time, an increase in San Diego elder abuse or neglect could occur as many seniors are institutionalized or transitioned into programs where initially caretakers will not be familiar with individual residents’ needs.

California’s ADHC system was initially designed to be a cost effective way to keep elders healthy while still enabling them to remain in the community. Seniors involved in the program typically attend adult day care centers a few days per week, which allow them to participate in group activities and exercise. Qualified personnel such as nurses, physical therapists, occupational therapists, and social workers are generally present to help address any medical needs.

The threat of budget cuts has already caused 23 adult day care centers to close this year. Three others plan to close by the end of November. At the end of the year, according to the San Jose Mercury News, the state will end $169 million in annual Medi-Cal funding for 35,000 people in 287 adult day health care programs throughout California, that is, unless a pending lawsuit blocks the state’s plan.

Despite the concerns of staff currently working at adult day care programs, state leaders say there are alternatives to institutionalization or to family members bearing the entire burden of caring for their loved ones. State leaders are transitioning elders and disabled individuals into Medi-Cal managed care plans. They also hope to expand programs that help coordinate care and provide in-home services and other support. Norman Williams, spokesman for the California Department of Health Care Services, stated that the department’s “top goal is to make sure recipients are transferred into services that meet their needs and allow them to remain in the community.”

However, Disability Rights California and other groups have sued the state, seeking a preliminary injunction to block the budget cuts. The lawsuit alleges that the plan will deprive people of their rights under the Americans with Disabilities Act (ADA) because it fails to do enough to enable them to remain in the community and to avoid institutionalization. The ADA prohibits discrimination based on disability and provides protections for Americans who suffer from a “physical or mental impairment that substantially limits a major life activity.” As seniors are shuffled around in order to accommodate state budget cuts, North County elder abuse lawsuits also may be filed if elders are harmed during the transition.

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old%20person.jpgAccording to a recent report by All Voices, understaffing is a prevalent problem in local nursing homes. Our San Diego nursing home abuse attorneys know that understaffing at Southern California nursing homes is a serious issue because it has consistently been shown to lead to increased instances of elder abuse or neglect. For example, at facilities where there is understaffing, caretakers may become frustrated and impatient with residents who need extra care and attention. When nursing home employees are overworked due to understaffing, residents often face a higher risk of injuries—e.g. from wandering or falls—due to inadequate supervision.

The latest report listed California as one of the states with the highest rate of elder abuse. Approximately 33% of nursing homes have been reported for abuse. According to the report, 89% of those abused in nursing homes never report their abuse. Tragically, per the reasonable standards laid out by a variety of organization, a tragic 90% of nursing homes do not have adequate staffing. Clearly, it is a problem that can have serious implications for California nursing home residents and their loved ones. Specifically, understaffing can lead to many significant problems, including: low staff to patient ratios, under training, high levels of staff stress and burnout, high staff turnover, false charting, and under- or over-medication.

According to the Center for Disease Control’s 2004 report on nursing homes, the current nursing staff to patient ratio is 1 nursing staff member for every 1.64 residents. Low staff-to-patient ratios mean that employees must undertake too many tasks, so there is not enough time for staff members to spend adequate time with residents. The result is that the amount of time recommended per day for staff to spend with residents is not being met. For example, the federal government suggests that staff members should spend 3.45 hours per day with a resident. Nursing home experts recommend even more face time with staff at 4 hours per day. The U.S. Department of Health and Human Services recently proposed requiring nursing home aides to spend a minimum of 2 hours per day with each resident, but 53% of nursing homes presently do not meet this standard.

Another serious effect of understaffing is that nursing home staff may be undertrained. Since staff-to-patient ratios are often so low, employees are frequently faced with completing tasks that they have not been trained to perform. Our Orange County elder abuse lawyers previously explained that facilities where staff members feel supported and well trained also report better rates of satisfaction from their residents. When understaffing occurs, however, nursing home employees usually experience high levels of stress and burnout, which frequently leads to high rates of staff turnover. Staff turnover disrupts patient care and also contributes to the problem of inadequate training. If staff members are stressed out and burnt out, they can lose compassion and respect for their residents, which can lead to California elder abuse.

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Falls are a serious problem in California nursing homes and can have serious health consequences for elderly residents. The attorneys at the Walton Law Firm know that a nursing home with 100 beds will have approximately 200 falls a year, many of which will go unreported. Nursing facilities should prevent falls for their residents whenever possible. Serious falls in custodial settings can result in death or drastically alter the quality of living for California seniors.

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To prevent falls, nursing home residents should be evaluated for their fall risk when they are admitted, and that assessment should be updated as a resident’s condition changes. Caretakers should consider a resident’s medical conditions and other possible risk factors, such as a resident’s overall mobility or access to fall prevention devices such as bed or tab alarms.

According to a report at Petaluma360.com, a Petaluma woman has filed a California nursing home abuse lawsuit, alleging that her 80-year-old mother suffered from malnutrition, dehydration, and infection that resulted in hospitalization due to nursing home negligence, neglect, and misrepresentation. The woman claims that her mother sustained several injuries, including a broken hip, while receiving home care from Accentcare Home Health of California, Inc.

Nursing home falls can occur for a number of reasons such as inadequate fall risk assessment upon admission, inadequate staffing, and/or inadequate supervision. The Petaluma lawsuit alleges that the senior fell while at home because home health care workers left her unattended even though they knew she suffered from dementia and was at risk for falls. Improper monitoring is a common mistake that caretakers in nursing home facilities make. As our attorneys know, those facilities must make provisions for adequate staffing in order to prevent dangerous falls which includes noting the residents that require close observation.

After her fall, the senior in this case lived at Petaluma Health and Rehabilitation where she was to receive more intensive care. While living there, however, the elderly woman was allegedly denied appropriate care and treatment that included food, hydration, wound care, monitoring, and assessment. As a result, she was hospitalized for malnutrition, dehydration, and serious infections. The elderly woman is now in hospice care.

The allegations against the Petaluma Health and Rehabilitation include failure to provide an adequate number of qualified staff to carry out all functions at the facility. The family of the injured woman claims that an employee misrepresented the quality of care that their mother would receive at the facility, namely that their mother would receive the care and services of specialists and staff that did not exist at the facility.

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Our San Diego nursing home abuse lawyers help families every day who are concerned about the care their loved ones are receiving at California nursing facilities. We know that seniors are valued members of our society and that they deserve the best possible care. We also strongly believe that poor care should not be tolerated under any circumstances.

Recently, a large verdict was awarded in a serious elder abuse case in West Virginia. According to reports in the Charleston Daily Mail and The State Journal, earlier this year, a jury awarded $91.5 million to the family of 87-year-old Dorothy Douglas, finding that the nursing home’s serious neglect caused the elderly woman’s 2009 death. The plaintiffs’ claimed that Ms. Douglas died as a result of severe dehydration and neglect from the nursing home. After less than three weeks at the facility, the elderly woman was in a comatose state, unresponsive, not walking, and not able to feed herself. According to the family, Ms. Douglas’ son worked tirelessly to have his mother transferred out of the facility, but paperwork problems prevented the transfer. Sadly, Ms. Douglas passed away from complications from dehydration before a change could be made. elder%20abuse.jpg

The jury decided that the family should receive $11.5 million in compensatory damages as well as $80 million in punitive damages, indicating that the jurors wanted to send a strong message to the nursing home. When the verdict came down, debate ensued due to the size of the award and regarding whether state medical liability caps should apply. Medical liability caps are sometimes created because state legislators fear increased insurance costs and diminished availability of professional liability insurance. In this case, the jury returned a verdict that 20 percent of responsibility for the negligence claim dealt with medical professional negligence and 80 percent was ordinary negligence. That likely means that 20 percent would fall under the legislation, but 80 percent would not. At the time, West Virginia Association for Justice President Paul T. Farrell Jr. explained that $11 million was awarded for the death and $80 million was awarded to punish the nursing home for intentional misconduct.

Debate has again arisen because a circuit judge recently entered a judgment order reducing a portion of the $91.5 million jury award, according to the Charleston Daily Mail. The judge’s order reduced a $5 million segment of the award to a maximum of $4,594,615, but did not significantly reduce the total jury decision as the defendant nursing home had hoped.

Large verdicts in San Diego nursing home negligence lawsuits are not only possible, but can often be appropriate. Such verdicts can call attention to improper care in nursing homes and send a message that when nursing facilities in California and elsewhere fail to comply with health care standards, tragic consequences can occur. Unfortunately, it is often the people who are responsible for caring for our elderly loved ones who commit acts of abuse or neglect—whether it is emotional, physical, sexual, or financial abuse.

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senior%20man.jpgOur San Diego nursing home abuse lawyer understands the seriousness of elder financial abuse and knows how it devastates the resources of California families. Unfortunately, like all forms of elder abuse, financial abuse of seniors is underreported and all too common. We realize that many California residents may be worried about elderly loved ones being taken advantage of by a caretaker or scammer, but knowing about a few simple warning signs can help ease those fears. For example, unexplained bank withdrawals, the disappearance of valuables, or sudden changes in a loved one’s behavior are all warning signs that a friend or relative may be a victim of financial exploitation.

The decline of the economy and the high numbers of aging Baby Boomers have recently revealed more and more instances of financial scammers who prey on the elderly. Earlier this year, the California elder abuse attorneys at the Walton Firm learned about a con man who posed as a licensed contractor and solicited home repair and remodeling projects from seniors in several California towns. The contractor never completed the promised services and then disappeared with the elderly victims’ money.

According to a report in The Monterey County Herald, the con man, Timothy Ralph Carrillo, formerly from Sand City, was sentenced last week to 35 years in prison for stealing more than $100,000 from people who believed they were paying for home repairs. He was convicted in August of this year of 24 counts, including California elder financial abuse, residential burglary, grand theft, and contracting without a license. Because the con man had a prior conviction for residential burglary, his sentence was doubled under California’s three strikes law. He also had prior felony convictions for commercial burglary, grand theft, and obtaining money by false pretenses.

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