California Nursing Home Abuse Lawyer Blog

March 12, 2012

Federal Report Finds State Oversight of California Nursing Homes Deficient

Last week, the federal government issued a new report that scrutinizes California nursing home inspections. The report finds those inspections lacking because inspectors fall far short in following up on their own investigative findings into problems at nursing facilities across the state. The California Department of Public Health is responsible for inspecting the state’s 1,150 nursing homes. Our San Diego County nursing home abuse lawyers have successfully sued nursing homes and residential facilities for neglect and abuse for years, and our firm is recognized as a leader in this area of law. As a result, we are familiar with how important it is for state officials to conduct thorough and accurate nursing home inspections.

The Department of Public Health (DPH) enforces both state and federal regulations that govern California nursing homes. However, the state and federal systems follow different rules and can levy different fines and sanctions when nursing homes commit violations. According to the DPH, it receives about 19,000 complaints and facility-reported issues each year. The DPH instructs inspectors to first examine problems in light of state laws that allow them to levy fines of $1,000 to $100,000. Those fines can be levied for a number of reasons, including, for example, a finding of San Diego elder neglect or abuse.

The recent federal report examines how well state inspectors from the DPH enforce federal regulations. When state inspectors fail to follow up on their inquiries, it can potentially enable sustained neglect or lax practices that can injure residents, according to a report from California Watch. The federal report, which was issued by the Department of Health and Human Services’ Office of Inspector General, examined the handling of 178 findings of deficiencies at three nursing homes that send a high rate of patients to nearby hospitals with painful bedsores and severe infections. The inspector general found that nursing home regulators underestimated the severity of problems in 13% of the findings.

March 5, 2012

High Numbers of San Diego Abuse Cases for Disabled Adults, but Few Prosecutions

by Nursing Home Law Group

Despite high numbers of substantiated patient abuse cases at California institutions caring for disabled adults, a recent article in the San Diego Union-Tribune reports that there are very few subsequent prosecutions. This disparity came to light after California Watch, a watchdog agency that frequently focuses on issues such as the public’s health and welfare, blew the whistle. The agency published a series of reports about flawed investigations conducted by a police force responsible for scrutinizing instances of potential abuse or death at state institutions for disabled adults. Our San Diego elder abuse lawyer has handled several cases against state-run facilities for the developmentally disabled, so our firm understands the unique and complex issues that such cases raise. For example, in cases involving dependent adults, many victims may not be able to adequately describe the abuse they have suffered making it crucial for their advocates to investigate all issues suggesting a pattern of neglect or abuse. crime%20scene.jpg

The Office of Protective Services (OPS) is a police force dedicated to investigating patient deaths and suspicious injuries at state-run facilities in California. However, since 2006 there have been 327 substantiated patient abuse cases and 762 unexplained injuries at five state-run institutions, yet few of those cases have led to prosecutions. The board-and-care institutions—located in Sonoma, Los Angeles, Riverside, Tulare, and Orange counties—are home to approximately 1,800 patients with cerebral palsy, severe autism, and intellectual disabilities. The relatively few prosecutions, as well as suspicious circumstances in certain cases, suggest that the OPS investigations are seriously flawed.

In one instance, a 50-year-old patient at Fairview Developmental Center in Orange County was found on his bedroom floor with a broken neck in 2007. The man died six days later. In spite of the suspicious circumstances, including the man’s relatively young age, police at the institution did not collect physical evidence from the scene while investigating the Orange County suspicious patient death. They also waited five days before beginning to interview potential witnesses. No arrests were ever made in the case, and it is possible that it will never be clear exactly what happened due to the shoddy investigative work.

February 27, 2012

Better Access to Primary Care Can Help Prevent Hospitalizations for San Diego Seniors

by Nursing Home Law Group

insurance%20health.jpg Data released by a new statewide study shows that better access to preventive and primary health care could have kept thousands of Californians out of hospitals, according to the North County Times. Earlier this month, the Office of Statewide Health Planning and Development released the study, which found that high numbers of “preventable hospitalizations” are an indication of systemic shortcomings related to access to quality primary care. With all of the recent uncertainty surrounding California’s Adult Day Health Care program, our San Diego elder abuse lawyers know that many local families are worried about finding affordable access to medical care for their loved ones.

The statewide study found that there were more than 335,000 adult hospitalizations in California that could have been avoided if the patient had seen a doctor sooner. Good primary care up front can prevent future hospitalizations. Seniors are particularly vulnerable to receiving poor care and should visit doctors regularly to help maintain their current health. Although the data on preventable hospitalizations does not necessarily indicate poor hospital care, the study did report 334 incidents in some type of surgical equipment was left inside a patient’s body, as well as 8,230 cases in which patients were accidentally cut or punctured during their hospital stay. At least some of those accidents were probably the result of negligent care, in which case a San Diego medical malpractice lawsuit likely would be appropriate.

A lack of preventative health care also takes a large financial toll on state resources, as well as on family members. For example, the Centers for Medicare & Medicaid Services published a report last year that noted that 26% of all patients who are eligible for Medicare and Medicaid had avoidable hospitalizations. The total cost to taxpayers in 2011 was more than $7 billion.

February 21, 2012

Nursing Home Falls Usually Caused By Systematic Negligence

by Nursing Home Law Group

Learning that a loved one has been harmed in a custodial setting due to neglect or abuse is a horror that hopefully most San Diego families will never have to face. But as California’s elderly population ages, the number of seniors living in nursing homes and assisted living facilities is sure to increase. When our San Diego nursing home abuse attorneys evaluate a case involving the custodial treatment of an elderly person, we investigate all issues that might suggest a pattern of neglect instead of what might initially appear to be a single negligent act. Doing so ensures that we obtain all the evidence necessary to make the best case possible. It also can help prevent similar occurrences at the same or other facilities, so that other families do not have to endure the pain of knowing that a loved one was harmed at a California nursing home. wheelchair%20back.jpg

Last week, a jury acknowledged the suffering that families endure when their loved ones are hurt at nursing homes. The jury awarded $8 million in damages to the estate of an elderly man who died shortly after his legs were broken when he was improperly transferred from a chair into his bed. The Courier-Journal reports that the man, who was in his mid-80s, was staying at a nonprofit nursing home.

After the man’s death, his estate hired a nursing home abuse lawyer to sue the negligent facility. The man’s injuries occurred because he was transferred without a lift and was moved by only one nursing assistant, in violation of the nursing home’s care plan, which required two assistants. Most qualified nursing homes maintain a “care plan” for each resident. Care plans should address falls, mobility, pain management, nutrition, bladder and bowels, among other things. Care plans should be updated on a regular basis to accommodate the changing needs of a patient and should be strictly followed. 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.

February 13, 2012

Patient Dies After Wandering Away From Nursing Home In the Cold

by Nursing Home Law Group

A nursing home patient with a history of wandering died in the cold, reports the Belleville News Democrat. Last month, the 77-year-old man walked away from the home where he was staying and later died. He had also wandered off two other times in the weeks and months prior to his final disappearance. Our San Diego nursing home abuse attorneys know that wandering can lead to serious injury or even death for people with memory impairment such as Alzheimer’s disease or dementia.

The state health department reported that despite the man’s previous wandering behavior, the senior—who suffered from dementia, kidney failure, and heart disease—was not wearing a patient monitoring device. The care plan established by the nursing facility also failed to address the man’s prior attempts to leave the home. The man’s body was found in a creek one block south of the nursing home. The temperature dropped to below freezing on the night he disappeared. He died of hypothermia, likely several hours after he wandered off.

Approximately an hour after the man was last seen, the police were contacted, and an extensive search was undertaken. The police immediately searched around the facility, conducted a second search at midnight, and then conducted a third search by helicopter in the early morning hours. Despite these efforts, the man’s body was not found until two days later.

February 6, 2012

California Nursing Home Abuse Investigation Uncovers Prescription Errors

by Nursing Home Law Group

A state investigation conducted by health officials has uncovered a widespread problem in California nursing homes, reports a recent article in The New York Times. Officials found that pharmacists responsible for reviewing the medication of California nursing home patients routinely allowed inappropriate and potentially deadly prescriptions of antipsychotic medications. The California Department of Public Health (CDPH) found that in 18 out of 32 investigations between May 2010 and June 2011 pharmacists failed to note cases in which elderly patients were inappropriately given powerful antipsychotic drugs.

In one instance, an elderly woman with a history of seizures was prescribed Seroquel, a strong antipsychotic drug (often used to treat schizophrenia), even though research shows that seniors who take antipsychotic drugs are more likely to experience seizures. She was also prescribed Trazodone, an antidepressant that has been linked to an increase in seizures in elderly people, as well as a second antipsychotic drug called Risperdal. Such a combination is potentially lethal, according to state investigators, because they can cause life-threatening heart arrhythmias. Our San Diego nursing home abuse lawyer knows it is essential for caretakers and doctors to be aware of the ways in which certain medications can impact elderly patients. Otherwise, dangerous side effects may occur, or medications that likely should not be combined with other drugs may be prescribed by mistake.

Under California nursing home abuse law, consulting pharmacists who work for nursing homes must review patients’ charts monthly. They then make recommendations to treating physicians about whether medications should be ceased, reduced, or changed, if they pose potential hazards or are causing harmful side effects. The CDPH discovered that California pharmacists failed to identify the misuse of antipsychotic medications in 90% of cases. The CDPH also found a “probable correlation” between faulty druggist reviews and the amount paid to pharmacists: in 59% of the cases involving defective reviews, nursing facilities had been cited for accepting pharmacy services below cost. The average pay rate for pharmacists in California is approximately $56 per hour, but instances were uncovered where pharmacists were paid as little as approximately $23, $16, or $11 per hour.

January 31, 2012

American Academy of Neurology Says Doctors Should Routinely Screen Patients for Abuse

by Nursing Home Law Group

senior%20in%20the%20dark.jpg 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.

January 25, 2012

California Elder Financial Abuse Continues Into the New Year

by Nursing Home Law Group

Elderly victims of financial abuse, like those suffering from other forms of abuse, are usually reluctant to report their abusers. In the case of financial abuse, many California elders may not even be aware they are being victimized. Our North County elder abuse lawyer knows that financial abuse makes up a significant portion of all elder abuse cases reported each year. Despite increasing awareness of elder financial abuse, many instances of this conduct are still occurring as California’s elderly population grows.

Two recent news articles again have shed light on the problem of California elder financial abuse. The Napa Valley Register reports that a Calistoga woman pled guilty to California elder abuse and tax evasion. The 51-year-old bookkeeper had been hired to manage an elderly woman’s financial affairs relating to the operation of the victim’s bed and breakfast in St. Helena. Instead, the bookkeeper embezzled more than $250,000 from the Yolo County woman over the course of 7 years, transferring the victim’s assets to other accounts to pay her own bills. The crimes apparently were discovered after the 80-year-old victim became ill and her family realized her assets had been depleted. Insurance%20Fraud.jpg

The Yolo County District Attorney’s Office decided to prosecute the Calistoga woman after learning that she had used the victim’s money to pay personal bills and purchase rental property in Santa Rosa and vacation property in Oregon. Although the woman will not be sentenced until March, she has already agreed to forfeit more than $300,000 in cash and property to pay restitution to the victim.

January 17, 2012

Government Report Finds Errors At Hospitals Frequently Go Unreported

by Nursing Home Law Group

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.

hosptial%20hallway.jpg 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.

January 11, 2012

New Requirements For California’s Adult Day Care May Mean Only Half of Prior Participants Will Qualify

by Nursing Home Law Group

Uncertainty about the future of California’s Adult Day Health Care system continues even though the program was saved from elimination at the end of last year. Since the 1970s, California has been a pioneer in the field of adult day health care, creating a system designed to provide health and social services to the elderly and disabled. The Adult Day Health Care (ADHC) system was established to respond to instances of California nursing home abuse. However, recent state budgeting challenges led lawmakers to cut all Medicaid funding for the centers in order to save approximately $85 million. elder%20abuse%20mags.jpg

California elder abuse advocates quickly sued the state to halt the massive funding cuts. Communities across the state also voiced outcry over the cuts, including concern that elimination of the program would lead to more elder abuse and neglect. A settlement was reached at the last minute, according to an article in Kaiser Health News. The settlement will require the state to continue to fund a scaled-down version of the program for those who need it most. Under the terms of the settlement, California must still pay for the services through its Medicaid program but only for those who have severe illnesses, disabilities, or dementia. Strict new eligibility requirements will determine who may receive care.

The San Diego nursing home abuse lawyers at the Walton Firm know that many Californians may be concerned about the new ADHC program. The new eligibility rules will bring some changes. For example, to determine who will qualify for the scaled-down program, 200 state nurses have begun visiting centers around the state to review patient records. The state has guaranteed services to more than 9,000 Californians already. The remaining 26,000 prior participants will be evaluated on a case-by-case basis. State health officials have estimated that only about half of the 35,000 participants will qualify under the new rules, which were established to control Medicaid costs. But the number of former participants that could still qualify may actually be much higher, meaning that the state may not save very much money after all.