The County of San Diego paid $1.6 million to settle a case filed by Ruth Lomeo against Edgemoor Geriatric Hospital, a county-run nursing home.

According to the lawsuit, Lomeo, who was only 44, was given an overdose of fentanyl pain medication by nursing staff at Edgemoor and began to have trouble breathing. It took over 20 minutes for 911 to be called and for emergency help to arrive. It was alleged that the lack of oxygen caused brain damage, and that Lomeo now communicates like a five year old, and cannot care for herself.

The County of San Diego denies all the allegations, and states its decision to settle the case was a business decision to avoid a jury verdict.

The Des Moines Register reviewed 81 bonus payment programs in over 30 states and found that numerous nursing homes with a below-average care giving rating were receiving quality-of-care bonuses. The newspaper looked at eight federal bonus programs in states where regulatory violations by a nursing home do not automatically disqualify a nursing facility from receiving a bonus. The eight programs analyzed are costing taxpayers $313 million per year.

By way of example, the Grace Living Center in Oklahoma earned approximately $96,000 in bonuses during the last year despite federal records that show the home has been cite for more violations than the state or national averages. Toby Edelman of the nonprofit Center for Medicaid Advocacy called the bonuses “preposterous,” and pointed out the incongruity of the government taking money from bad facilities by issuing fines, then returning the money in the form of a bonus. “It just doesn’t make any sense,” Edelman said, “it’s totally confusing to consumers.”

Legislation approved earlier this year says the bonuses will continue at least through June 2009.

It is hoped that a new California law which will go into effect January 1, 2009 will cause increased reporting of thefts from elderly residents of nursing homes.

The new law will require police and facility ombudsmen to immediately report cases of known or suspected elder abuse, specifically including theft, to the local District Attorney’s office.

Elder theft in nursing homes frequently goes unreported. Nursing home administrators/owners claim that most thefts result from the elder “misplacing” their property. The reality is that most thefts do not get reported because it makes the facility look bad. It is hoped that the new law, which specifically requires facilities to report theft, will result in increased reporting of elder theft.

The California Long-Term Care Ombudsman Program is the state program responsible to investigate and resolve complaints made by individuals (or their representatives) residing in long-term care facilities such as nursing homes. Last week, when the California budget was signed by Governor Schwarzenegger, he cut state funding for the ombudsman program.

The decision has not gone over well with elder care advocates. The governor’s cuts removes roughly 15% of the budget for the program, which translates into a loss of 1.25 of every 3.7 positions.

To contact your local ombudsman’s office call the appropriate telephone number in the geographical area the incident leading to the complaint occurred.

A study just released by the Inspector General of the Department of Health and Human Services reports that 94% of all nursing homes nationwide were cited for violations of federal health and safety standards during 2007. Approximately 17% received deficiencies or citations for issues which caused “actual harm or immediate jeopardy” to residents. These deficiencies were for such things as bedsores, medication errors, lack of nutrition/dehydration, abuse and neglect of residents.

In total, inspectors received 37,150 complaints nationwide. Surprsingly, only one-fifth of the verified complaints involved the abuse or neglect of patients. The remainder were for adminsitrative issues or those related to the physical premises.

Another telling statistic is that 94% of for-profit nursing homes were cited whereas only 88% of non-profit nursing homes were cited. For-profit also received an average of 7.6 deficiencies per home whereas non-profits averaged 5.7 per home.

The New York Times is reporting this morning that 90% of all nursing homes were cited for violations of federal health and safety standards. Approximately 17% of U.S. nursing homes had deficiencies that caused actual harm. As mentioned in this blog previously, nursing facilities that operate “for-profit” were more likely to have problems than non-profit homes.

Federal inspectors received 37,150 complaints in 2007 about nursing home conditions, the bulk of which involved bed sores, abuse and neglect of residents, medication errors, and nutritional issues. Failure to sufficiently staff was noted as a particular concern in the report, including the allegation that nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” Not surprisingly, researchers learned that elderly patients receive better care at homes with a higher ratio of nursing staff members to patients.

The U.S. has approximately 15,000 nursing homes, housing nearly 2 million people. Under the laws of most states, including California, these homes are inspected once a year.

Elder abuse or neglect in the nursing home is a fear many elderly Americans face. A case unfolding in Illinois is about as bad as it gets.

According to a report from the states Department of Public Health, several suspicious deaths at the Lake of the Hills nursing home may have been the result of a nurse deliberately overdosing troublesome patients. A year-long investigation into the deaths revealed that nurse Marty Himebaugh boasted to coworkers that she gave patients she felt were difficult or had “lived long enough” a drug cocktail that contained morphine sulfate, now suspected as the cause of several deaths.

I one particularly horrible finding, the nurse was reported as telling a coworker that, “those people aren’t meant to live that long,” referring to an adult resident who suffered from Downs syndrome, “they are meant to die in their teens and I’m going to help him along.”

On Wednesday, the Senate Finance Committee approved two bills which will help prevent neglect and abuse of elderly persons.

A frequent source of abuse are caregivers who are repeat violent offenders. A bill (S 1577), sponsored by Sen. Herb Kohl (D-Wis.), would create a nationwide background check system to screen long-term care employees for a history of abuse or a violent criminal record prior to hiring.

A seven-state pilot program established under the 2003 Medicare law already exists and would be expanded by this bill. The bill would provide as much as $160 million in grants over three years to states which seek to participate in the program. This law would help keep violent offenders from working in nursing homes with particularly vulnerable elderly patients.

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 Elder Abuse
Brighton Convalescent Center 05/23/08 Class B
Heritage Manor 03/7/08 Class B
Imperial Convalescent Hosp 03/26/08 Class B
Ramona Care Center 05/23/08 Class B
Studio City Rehabilitation Center 02/21/08 Class A
Villa Oaks Convalescent 06/23/08 Class B
Windsor Convalescent Long Beach. 05/22/08 Class B
Windsor Palms Artesia 05/23/08 Class A
Orange County
Evergreen Fullerton Healthcare 04/15/08 Class B
French Park Care Center 05/20/08 Class B
Kindred Healthcare of Orange 04/29/08 Class B
New Orange Hills 04/16/08 Class B
Parkview Healthcare 04/15/08 Class AA
Riverside County
Cypress Gardens 06/10/08 Class AA
San Diego County
Edgemoor Geriatric Hosp. 06/26/08 Class A
Cypress Gardens Rehabilitation 03/20/08 Class A
Lemon Grove Care & Rehab. 07/16/08 Class B
Villa Las Palmas 07/01/08 Class B
Vista Healthcare 04/11/08 Class B
Santa Barbara Nursing Home Neglect
La Cumbre Senior Living 07/24/08 Class B & A
Country Oaks Care Center 5/20/08 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.

Elder Law and Advocacy in San Diego has been providing free legal services for seniors for 30 years, and was profiled in today’s San Diego Union Tribune. Whether it’s drawing up a will or a power of attorney, helping with a problem landlord, or answering questions about Medicare, Elder Law and Advocacy has assists several thousand San Diego County every year.

Walton Law Firm LLP has worked with Elder Law and Advocacy on cases involving nursing home abuse and neglect and can vouch for the organization’s dedication to the plight of senior citizens.

Carolyn Reilly is the executive director of Elder Law and Advocacy, and says that the demand for free legal services for the elderly is rising – keeping her eight lawyers busy – while the funding for those services remains slim. Elder Law operates on a tight budget, with the vast majority of its income coming from grants and individual contributions. This is a worthy organization that deserves the public’s support. It is well-known that a large part of our population is getting older, and organizations like Reilly’s will only become in greater demand.

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