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

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The Ombudsman Services of Northern California, an organization dedicated to creating a corps of compassionate advocates for residents in long-term care facilities believes that state budget cuts to its ombudsman program will lead directly to an increase in cases of elder abuse and neglect.

This year the organization, which tracks approximately 1,600 nursing homes and assisted-living facilities, lost two-thirds of its staff due to shortfalls in the state budget. According to Joan Parks, nursing facilities are already taking advantage of the lack of oversight.

“Our monitoring in these homes was seen as a form of prevention,” Parks said.

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In increasing numbers, young and middle-aged mentally ill patients are being housed with older people in nursing homes. It has proved to be a dangerous practice for older residents. The younger, stronger, mentally-disturbed residents have lashed out at the older, frailer residents who often are defenseless against the attacks. Sons and daughters of the elderly victims of attacks are left wondering why their loved ones were not protected better.

In the past seven years, there has been a 41 percent increase in the number of mentally ill patients housed in nursing homes, which as led to a correlated increase in peer-on-peer physical abuse. The reasons for the increase are multi-fold, including the fact that states have failed to provide adequate facilities for the mentally ill. It is also financially advantageous to house the mentally ill and the elderly together. But while it may make financial sense, it puts the elderly at risk and inadequate measures have been taken to protect the elderly.

Under state and federal law, nursing home residents are guaranteed freedom from physical abuse. At Walton Law Firm LLP, we have represented victims of violent attacks in nursing homes. These attacks are often a result of negligence on the part of the facility including a failure to provide adequate staffing. If you have questions about the care of your loved one in a nursing home, please contact Walton Law Firm LLP for a free and confidential consultation.

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Every year the typical nursing home will report approximately 1.5 falls per bed, and most falls go unreported. In fact, studies show that 75% of nursing home residents will fall at least once in a year, and nearly one-third of those involve a resident who is deemed non-ambulatory. Sadly, approximately 1,800 people living a nursing facility die every year due to a fall.

Can falls be prevented? Yes, and they should be. With proper care planning, many if not most falls can be prevented in the skilled nursing setting. For example, each resident must be accurately assessed on a regular basis for risk of falling, and when there is a fall, proper assessment must be performed to determine the cause of the fall, and how another might be prevented in the future.

In addition, physical changes in the nursing home can help prevent falls, including the placement of grab bars, lowering beds, and raising toilet seats. Bed alarms can also prevent a fall in a resident who is a known risk.

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Escondido Nursing Center received the state’s most severe citation – a AA – after the choking death of an elderly resident. According to reports, the 180-bed facility failed to modify the resident’s nutrition plan after his physician placed him on a special diet because of chewing and swallowing difficulties. During lunch on November 30, 2008, the resident suffocated when food got stuck in his wind pile. He had been given beef and carrots.

Class AA citations are relatively rare in California, with only about 20 being issued annually. In our view, this isn’t enough. As nursing home abuse and neglect attorneys, we have investigated numerous horrendous cases of neglect similar to this one (actually, many are worse), where an investigation is completed by the California Department of Public Health and no citation is issued. This may be a good sign that the new leadership at CDPH is changing the culture and encouraging the department to be more willing to enforce California state law as the people expect.

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U.S. News & World Report is out with an article on the common problems found in U.S. nursing homes in an interview with attorney Eric Carlson, author of 20 Common Nursing Home Problems. As a nursing home abuse lawyer, I found the article enormously helpful; particularly the answer to the first question, which I think is the most important:

What can consumers do to best protect themselves up front?

Be aggressive about questioning a prospective home about staffing and staff training. A nursing home generally receives $4,000 to $9,000 a month for the care of one resident, so it should be responsive to both residents and potential customers. Talk to residents and visitors without nursing home staff hovering nearby. Visit several times, at different hours and on different days. Make at least one visit at mealtime. Examine inspection reports. Each nursing home that accepts Medicare or Medicaid payment is inspected approximately once a year. And the National Citizens’ Coalition for Nursing Home Reform offers a consumer guide to getting good care in a nursing home.

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Many nursing homes are now marketing themselves as “rehabilitation” facilities in an effort to attract the ideal resident: one who stays under 100 days then goes elsewhere. Why? Because Medicare provides lucrative fees for skilled nursing care. It is not uncommon for nursing homes to discharge residents, often prematurely, when the Medicare benefits end.

Most people are unaware that when Medicare coverage ends, a resident who needs skilled nursing care has a right to stay, either by paying privately, or qualifying for Medi-Cal coverage. Under Welfare and Institutions Code section 14124.7, no nursing home that accepts Medi-Cal payments can evict, or transfer within a facility, any person who changes the manner of paying from private or Medicare to Medi-Cal.

For more information on discharge and transfer rights in California nursing homes, see the fact sheet provided by California Advocates for Nursing Home Reform.

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This list contains the issuance of citations to Southern California nursing facilities by the California Department of Public Health over the last six months. All the citations listed are issued for reasons related to patient care. For verification of the citation, please contact the local department office or Walton Law Firm LLP.

 

<font size=’2′Facility Date Citation
Los Angeles County
Briarcrest Nursing Center 10/28/08 Class A
Casa Bonita 12/09/08 Class A
Casa Bonita 12/19/08 Class AA
Chatsworth Park Care Center 12/22/08 Class B
Country Manor Healthcare 11/21/08 Class B
Del Rio Convalescent 10/10/08 Class B
Hillcrest Care Center 7/28/08 Class B
Inglewood Health Care Center 11/18/08 Class B
Santa Monica Health Care Center 12/05/08 Class B
View Park Convalescent Center 01/12/09 Class B
Windsor Convalescent North Long Beach 09/25/08 Class B
Orange County
Anaheim Crest Nursing Center 01/30/09 Class AA
Flagship Healthcare Center 01/06/09 Class B
Palm Terrace Healthcare & Rehab Center 12/22/08 Class A, B
Riverside County
Extended Care Hospital Riverside 12/04/08 Class B
San Diego County
Care With Dignity Convalescent 11/06/08 Class B
Carmel Mountain Rehabilitation 01/07/09 Class B
La Jolla Nursing and Rehabilitation. 12/12/08 Class B
Ventura County
Camarillo Healthcare Center 12/18/08 Class A
OakView at University Village 1/28/09 Class B
Shoreline Care Center 1/28/09 Class B
Camarillo Healthcare Center 12/18/08. Class A
Victoria Care Center 12/18/09 Class B

 

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

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Just before leaving the White House, President Bush enacted a rule that designates state inspectors of nursing homes as federal employees, making it more difficult to obtain evidence obtained by those inspectors in private lawsuits against nursing homes for abuse or neglect, such as those pursued by Walton Law Firm LLP.

The new restriction affects about 16,000 nursing facilities in the United States, and will require litigants to go to greater lengths to obtain information that used to be routinely given. In short, the rule prohibits state health departments (such as the Department of Public Health in California) from participating in private lawsuits that are in the federal assistance program.

Bloomberg.com has more on the story here.

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California ombudsman Nona Tolentino’s job is to investigate cases of suspected elder abuse in nursing homes. Her conclusion after years as in the business: be afraid, be very afraid.

The biggest problem Tolentino faces is trying to prove the allegations. “I call it the conspiracy of silence,” she said, because many nursing home residents and their family are reluctant to talk about, frequently out of concerns of retaliation or being evicted from the facility. Tolentino believes strongly that nursing home residents have fundamental rights to be free from physical and verbal abuse, unnecessary restraints, or involuntary seclusion.

Tolentino is mostly right. If one were to visit the local office of the California Department of Public Health and pull the file of any large nursing home in the region where they lived, they would be startled by the number of complaints made and investigated. More troubling, however, would be the realization that the vast majority of complaints are “unsubstantiated;” meaning the investigator could not prove the allegations are true.

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Three California nursing home employees were arrested yesterday for allegedly injecting 22 residents with mood-altering drugs to keep them quiet and restrained. According to the criminal complaint, a nursing director, a pharmacist, and a physician drugged the residents in order to keep them compliant and easier to care for. Three of the patients died.

“These are powerful medications that were given, in some cases against people’s will, primarily for management, not health reasons,” said California Attorney General Jerry Brown. “It’s unconscionable behavior and it’s certainly not what people expect when they entrust their parents or grandparents to a skilled nursing home.”

The allegations in the criminal complaint are appalling, including residents becoming “zombie-like” and unable to eat or drink for days, causing severe malnutrition and dehydration. The three residents who died were Fannie May Brinkley, Eddie Dolenc, and Joseph Shepter. At least one civil lawsuit has been filed as a result of the deaths, and more are expected.

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