The nursing home industry (and nursing home lawyers) was stunned earlier this year when a Humboldt County jury returned a class action verdict against the nursing home chain of $677 million dollars. The plaintiffs alleged, and the jury believed, that Skilled Healthcare, the owner of many nursing homes in several states, routinely understaffed its California nursing facilities, compromising patient care in an effort to maximize profits.

The case was a battle. ”Everything was fought tooth and nail,” Timothy Needham, lead trial lawyer for the team of plaintiff lawyers told the Times-Standard. The trial lasted six months. But the verdict was so big it created practical problems for the victors, and potentially fatal concerns for Skilled Healthcare, a publically traded company. Because of the size of the verdict, Skilled Healthcare could not afford to pay such a huge judgment and could not appeal the result (appeals require the posting of a bond, which is a percentage of the verdict), and the plaintiffs really didn’t want to take over the company. So, smartly, everyone agreed on a settlement.

It was announced yesterday that the verdict of $677 million was settled for $62.8 million.

The giant nursing home neglect verdicts continue to come in around the country. Last week, a jury in Kentucky awarded the family of a neglected nursing home resident $42.75 million after the resident became lethally dehydrated and malnourished, and arrived at the hospital covered in bed sores. The resident died as a result.

According to news accounts, 92-year-old Joseph Offut had been a resident of Harborside nursing home for only nine days prior to his death. The World War II veteran had been very active up until the age of 90, when he suffered a stroke and was cared for by his wife of 58 years. Like many, after some difficult conversations the family ultimately decided that Mr. Offut needed professional care and placed him in a nursing home.

After his death, Offutt’s family filed a lawsuit for wrongful death against the nursing home’s parent company, Sunbridge Healthcare Corp. The lawsuit alleged that caregivers at the nursing home neglect Offut, causing him to suffer severe dehydration, malnutrition, decubitus ulcers, and ultimately death.

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.

The California Department of Public Health issued its most severe citation to a California nursing home following the death of a 97-year-old resident. According to reports, the Gramercy Court nursing home patient fell out of her bed and onto the floor while a nursing assistant had her back to the patient. The resident suffered a spinal injury and died a short time later.

State investigators said the fall could have been prevented if the bed rail, which was ordered, had been in place. As a result, a AA citation was issued against the facility, and a $90,000 fine assessed. The maximum fine allowable under California law is $100,000.

To read the entire AA citation, CLICK HERE (.pdf).

At Walton Law Firm, we have handled numerous cases involving decubitus ulcers or bed sores, many of them resulting in the death of the patient. But the cases we handle are civil cases; a prosecution of the nursing home or other caregiver to seek money damages. We have never seen any caregiver prosecuted criminally for such neglect.

090903_jean_rudolph.jpgIn Washington State, however, the owner of an assisted living facility and an employee were charged with crimes for the neglect of Jean Rudolph, who died under their care. When Rudolph died in 2008 at the age of 87, she weighed only 68 pounds. The cause of death was related to infections that were caused by bed sores so severe that they exposed her bones, including a hip sore so severe that her hip bone jutted out of her body.

Her son, who visited her twice a week, never knew of the sores. His mother suffered from end-stage dementia and couldn’t speak or express her needs, and each time the son visited she was always under covers.

A 72-year-old woman suffered burns on her hands and feet while under the care of an Escondido woman and her son at their home-based elder care facility. Mila Labayen, 74, and her son, Steve Perez Lopez, 50, face criminal charges for elder abuse arising from their failure to seek immediate medical attention for the injuries of the resident who suffers from dementia. In addition, Mr. Lopez is charged with draining $45,000 from the bank account of another elderly resident, who suffers from schizophrenia. Mr. Lopez allegedly took the money while out on bail for charges relating to the elder abuse claim. Alert bank employees alerted authorities to the suspicious withdrawal of money.

It is unclear what caused the 72-year-old woman’s burns, but by the time her daughter learned of her injuries and brought her to the hospital, her skin was already sloughing off, and she remained in the hospital’s burn unit for nine days.

The elder care home, Liberty Care Homes III, located on the 1100 block of Via Rancho Parkway, was owned and operated by Ms. Labayan and was licensed to provide residential care for up to six elderly people. The license was first issued in 1993. Liberty Care Homes III is now closed.

An 81-year-old nursing home resident beat his 94-year-old roommate to death with a closet rod in their Laguna Hills nursing home. Sheriff’s have arrested William McDougall of Mission Viejo for causing the death, and he has been booked for murder. The victim, Manh Van Nguyen of Laguna Woods, was pronounced dead upon arrival to Saddleback Memorial Hospital.

l9oh7z-l9oh6tmcdougall.jpg The motive in the killing is unclear. Both men were residents at Palm Terrace Healthcare and Rehabilitation Center, a licensed skilled nursing facility in Laguna Hills. (More info about the facility here) “What prompted the attack is still under investigation. Obviously, this is very unusual,” sheriff’s spokesperson Jim Amormino told the media. Staff at the nursing home have apparently told sheriff’s investigators that there no prior conflicts between McDougall and Nguyen.

What causes violence such as this in the nursing home? It could be a number of things. First, it is not uncommon for residents with memory impairment such as Alzheimer’s disease to act aggressively toward caregivers and others. Our law firm has represented victims of peer-on-peer abuse in the past. Another possibility is medications. What medications was McDougall on (or not on) that might have contributed to this offense. And, of course, maybe McDougall is just a violent person. No doubt all of this will be uncovered in the criminal investigation, which is just starting.

The California Department of Public Health has levied its harshest fine against a nursing home after a resident fell from a mechanical lift. According to reports, the lift was being to transfer a 60-year-old patient from her wheelchair and into her bed. As nursing assistants were transferring the woman, the sling holding the woman broke, causing the woman to fall hard to the ground. She struck her head on a nearby door, causing a severe brain injury, and ultimately causing her death four days later.

Lift.jpg An investigation by the Department of Public Health revealed that the nursing home, the Eskaton Care Center, failed to properly maintain the lift. The lift, which law required be checked monthly, had not been checked for five years. The DPH report stated that the sling appeared worn and had “what appeared to be bleached out blood stains at the center.”

The nursing home can appeal the fine (and the AA citation it received), but it’s not clear if it will. “We’re mortified,” Trevor Hammond, the nursing home’s chief operating officer, told the Modesto Bee. “We had a tragedy when a piece of equipment failed. It was a catastrophe.”

This story makes one wonder what would happen if a hidden camera sting was done in every nursing home. The attorney general of New York placed a hidden camera in a single room of a long-term care facility, which resulted in an indictment against nine nurses, the nursing home, for a whopping 169 separate crimes.

The indictment filed in the case alleges 57 instances of neglect during a three-month period in 2009. With the family’s permission, a hidden camera was placed in the room of a 53-year-old resident who suffers from multiple sclerosis and other mental and physical illnesses. The video revealed that the nurses failed, on several occasions, to turn the patient regularly as required, failed to medicate as needed, treat his pressure ulcers, or even change the resident’s clothing. Of course, in the medical chart, these nurses stated that all this care had been provided. The fraudulent medical charting resulted in further criminal charges.

In interesting footnote to the story, when the alleged abuse revealed, several people came to The Record newspaper to tell their stories of abuse or neglect inside the facility, including unanswered call lights and untreated infections and bed sores.

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