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An elderly man with Alzheimer’s disease died as a result of a nursing home’s negligent care according to a report released by the California Department of Public Health. According to the investigation findings, the nursing home resident also was noted to have dysphasia, or difficulty swallowing. While being fed by a certified nursing assistant, the man began to cough and gasp for air. Though in obvious distress, no telephone call to emergency response was made for 20 minutes (something caregivers lied about to DPH). When paramedics arrived approximately 10 minutes later, the man was already dead.

The DPH issued a AA citation and an $80,000 fine for its failures.

The nursing home, Homewood Care Center in San Jose, was owned by Jack Easterday. Mr. Easterday was sentenced to 2 1/2 years in prison in 2007 for his willful failure to pay employment taxes. He was the owner of a company called Westline Medical Management, which owned Homewood Care Center and several other nursing homes in California.

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SmartMoney.com has an article out entitled 10 Things Nursing Homes Won’t Tell You. Which has been adapted from the book “1,001 Things They Won’t Tell You: An Insider’s Guide to Spending, Saving, and Living Wisely,” by Jonathan Dahl.

Walton Law Firm thought you might like to see the list:

1. “We’re careless about the drugs we give out.”

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The California legislature has called for an investigation into why only one-third of the fines assessed against nursing homes for negligent care are being collected. The audit that was approved in February is expected to look how the funds are collected and how they’re spent.

Mike Feuer, D-Los Angeles told California Watch, “The whole point of having citation accounts and the penalty system is to deter nursing homes from doing anything but provide the highest quality care to residents. If the fines coming in are less than a third of (those) issued, it leaves one to wonder if the state is being as effective as it could be in protecting nursing home residents.”

Records obtained by California Watch reveal that in 2008 state regulators collected only $1.5 million of the $5 million that had been assessed against California skilled nursing facilities. In comparison, the same regulators have collected nearly 80 percent of the fines levied against hospitals. Kathleen Billingsley, the deputy director of the Department of Public Health Center for Healthcare Quality, said nursing homes who appeal fines do not have to pay until the process is completed.

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California Watch is out with a disturbing report alleging that California nursing homes that received more than $880 million in additional taxpayer funds under a law designed to boost care, took the money did the opposite by cutting staff and wages. [“Nursing homes received millions while cutting staff, wages“] In its investigation, California Watch found 232 California nursing homes that either cut staffing, or paid lower wages to workers after receiving money from the state.

It appears that many of the nursing homes investigated used the state money to improve their financial health, not the health of its residents, and those that cut the most staff had, not surprisingly, more deficiencies issued by state inspectors than those facilities that did not cut staff.

“There was an implicit good faith agreement that things would get better … and that was broken,” state Sen. Elaine Alquist, D-Santa Clara, told California Watch. “It was broken for the people of California and for a very vulnerable population – those that need the greatest care and those that can’t advocate for themselves.”

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The heirs of an elderly nursing home resident have sued the nursing home for causing the death of their father Oliver Shrock. The lawsuit alleges that caregivers at Kindred Healthcare Center in Orange County ignored the family’s warnings that Shrock was at risk for falling, and failing to take appropriate fall precautions, such as using a bed alarm. On July 14, 2008, just two months after his admission into the facility, Shrock fell and struck his head. He died four days later.

The California Department of Public Health investigated the 77-year-old’s death and concluded that the resident’s death was caused by the nursing home’s negligent care. A AA citation was issued, and an $85,000 assessed.

According to the lawsuit, Shrock fell shortly after admission, and that while some fall interventions were taken, they were used sporadically. For example, a bed alarm was used on Shrock, but only occasionally. The visiting daughters would repeatedly after to remind the facility to use it. Sadly, on the day of the fall, the bed alarm was not in place. It was the day Shrock was going to go home.

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It took jurors only five hours to convict 21-year-old Cesar Ulloa of criminal elder abuse for his brutal treatment of residents at the Calabasas nursing home where he worked. According to prosecutors, Ulloa would laugh as he attacked his victims, many of whom were to demented to be able to call for help. He faces life in prison.

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In one of the assaults, a fellow employee witnessed Ulloa jump on the chest of a non-verbal 78-year-old woman’s chest, and throwing her on the bed as she struggled. To another elderly male resident, Ulloa jumped off a dresser and landed with both knees on the man’s abdomen, seriously injuring the man. He apparently would laugh with delight while brutalizing the patients.

Suspicion over Ulloa actions was raised after the wife of a resident received an anonymous phone call the day after her husband’s funeral. The call said that her husband had been abused, and that his death may have been related to the abuse, something the family suspected. The police were notified, and the victim’s body exhumed for an autopsy that revealed more than 24 fractures. The man’s death was determined to be caused by blunt force trauma.

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Heritage Rehabilitation Center in Long Beach has been sued for a sexual assault that occurred there just last month. According to the lawsuit, filed by James Morgan, the victim “Jane Doe” was suffered elder abuse and neglect when a man entered her room through an unlocked window and assaulted her. The suit also claims there may be other victims.

The suit alleges that the nursing facility was chronically understaffed. According to Morgan, “This was an active time of the day and there was nobody anywhere, which supports our theory they didn’t have enough staff in there to look after residents or see people coming in from the outside.”

Heritage Rehabilitation Center is a 161 bed facility that has been in operation for more than 35 years. It currently maintains a three star (out of five) on Medicare’s “Nursing Home Compare” website.

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The healthcare reform bill signed by President Obama this week will have an impact on nursing homes and long-term care. The most dramatic change will come in the form of long-term care insurance, and provision that was long championed by the Senator Edward Kennedy. Under the Community Living Assistance Services and Support Act (CLASS), all Americans will automatically be enrolled in a long-term care insurance program, but will have the option to opt out.

Under the Act, individuals will start paying a premium immediately, and will be able to use the benefit after five years of contribution to the program. The benefit, though, is not much, as it is expected to be about $50 per day to offset other long-term care costs.

The healthcare reform bill will also start to close the “donut hole” in Medicare Part D coverage for prescription drugs. Patients will immediately begin receiving a rebate for drug costs that fall into the gap, and drug manufacturers will be required to provide a discount on brand name drugs. Over time, the gap in coverage will be phased out entirely.

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Last year, the U.S. Drug Enforcement Administration began investigating allegations that some nursing homes were dispensing powerful narcotics to nursing home residents without a physician order. Because of the new scrutiny, however, nursing home and hospice trade organizations are arguing that many patients are now being left without pain medication as the nursing facilities try to find ways to comply with DEA regulations. Congress has also taken notice, and the subject will be addressed at a Senate hearing today.

The DEA intensified its efforts to battle abuse of prescription drugs in nursing home, after numerous reports of overmedication of patients in nursing facilities, many without prescription, and frequently used as a “chemical restraint,” not to treat a specific illness. In a letter to Congress last December, attorneys for the DEA said that allowing nurses to dispense medications without a doctor’s order, “trivializes the doctor-patient relationship and weakens the quality of care for the frail and infirm.”

Nursing home trade organizations, however, say that long-term care facilities don’t make available enough doctors to issue prescriptions every time. The DEA’s requirement on “hard copy prescriptions,” it says, places burdens on prescribers, pharmacists and nurses, and can lead to extended delays in the administration of pain medication.”

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The Sacramento Business Journal is out with an article accusing the State of California of exposing elderly nursing home residents to dangerous caregivers because state regulators have failed to implement a 2006 law that requires the creation of a centralized database for background checks on all long-term caregivers.

According to the article, an investigation by the state’s Senate Office of Oversight and Outcomes discovered at least 20 incidents where individuals who lost their certification as nursing assistance because of wrongdoing were cleared and hired in a different facility.

“There is no excuse for allowing people with known histories of abuse to work in residential care facilities for the elderly or as caregivers in any other setting,” said Michael Connors, an advocate with California Advocates for Nursing Home Reform, a non-profit that advocates on behalf of nursing home and residential care residents.

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