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

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According to estimates, there are about 1.6 million people in the United States employed to provide home care for the elderly, and advocates for the elderly say the cases of abuse, neglect, and fraud by home caregivers is growing at an alarming rate. The increase is prompting calls for more government oversight as home-care assistance grows along side the aging baby boomers, and the desire of people to avoid nursing homes.

Because the bulk of home care is being provided by non-licensed or certified nurses, who are typically regulated under state, home caregiver frequently have no training, receive minimal pay, and loosely supervised. In California, home aides who do not provide medical care are not even required to pass a criminal background check.

To research the problem, the Centers for Medicare and Medicaid funded a study that screened 214,167 people who held jobs provided assistance to the elderly and discovered that over 5,000 of them had criminal histories. Advocates for the elderly are advising consumers to verify background checks from any agency that offers home care services, and those who hire directly are strongly encouraged to check references.

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About four years ago I had a very interesting case involving the death of a developmentally disabled adult in a San Bernardino care facility. In my case, the thirty-year old severely disabled man was found barely breathing on the floor next to his bed just after midnight. Medics were called, and tried to sustain his life, but sadly the man died. Staff and the family presumed it was a heart attack, since the decedent was very obese and had a history of some heart problems.

An autopsy, however, showed a different case of death. The medical examiner ruled the death a homicide, finding that the man died from blunt force trauma to his abdomen. The next question for use was Who did it?

Through the discovery process in a lawsuit we filed against the facility, we believed the death was caused by either a disgruntled employee, who was tired and angry at the resident for the demands he made on staff time, or an autistic room mate (who could not speak), who accidentally kicked the decedent in an act of self-defense. The case settled before trial, so those questions were never fully answered.

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Studies have suggested that approximately one-third of all nursing home residents suffer from some form of dehydration or malnutrition, a condition that can cause or aggravate more serious medical conditions, and may be caused by elder abuse or neglect.

Much of the problem can be attributed to poor staffing, whether inadequate numbers of staff, poor staff training, and a lack of individualized care. While California law requires 3.2 hours of certified nursing per patient, per day – a minimum number many nursing homes fail to meet – many experts believe the law is inadequate, advocating for an increase to 4.1 hours per resident, per day.

Karen Davis of the Commonwealth Fund, the funder of a report on nursing home care, says, “malnutrition, dehydration, and weight loss in nursing homes constitute one of the largest silent epidemics in this country.”

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The Robert Wood Johnson Foundation is donating millions of dollars to build small, home-like nursing homes as an alternative to the large institutional nursing homes we have come to know (and despise). Imagine what it would be like to have a country filled with nursing facilities like the one profiled in this video.

To read The Wall Street Journal article on the subject click here

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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
Alden Terrace Convalescent Hosp. 04/09/08 Class B
Chandler Convalescent 02/13/08 Class A
Chatsworth Park Care Center 03/13/08 Class B
Country Villa Park Marino 01/28/08 Class B(3)
Country Villa Pavilion Nursing 03/19/08 Class B
Ember Health Care 01/31/08 Class AA
Gardena Convalescent Hosp. 02/05/08 Class B
Heritage Manor 03/07/08 Class B
Imperial Convalescent 03/27/08 Class B
Lancaster Health Care Center 02/13/08 Class A
Oceanview Convalescent 02/20/08 Class B
Royal Oaks Care Center 12/11/07 Class B
Sophia Lyn Convalescent 04/14/08 Class B
St. John of God Retirement 02/27/08 Class B
Studio City Rehabilitation 04/02/08 Class A
Sunnyview Care Center 04/29/08 Class B
Tarzana Health and Rehab. 02/13/08 Class A
Whittier Hills Health Care Center 01/07/08 Class B
Windsor Palms Care Center of Artesia 04/15/08 Class B
Orange County
Country Villa Plaza Convalescent 03/12/08 Class B
Fountain Care Center 03/13/08 Class B
Newport Subacute Healthcare 02/06/08 Class A
Palm Terrace Healthcare & Rehab Center 02/01/08 Class AA
Park Regency Care Center 04/11/08 Class B
San Bernardino County Elder Abuse
Cherry Valley Healthcare 02/14/08 Class B
Country Villa Rancho Mirage 02/05/08 Class A(2)
Cypress Gardens Rehabilitation 03/20/08 Class A
The Springs At The Carlotta 03/21/08 Class AA
San Diego County
Children’s Convalescent Hospital 02/21/08 Class B
Edgemoor Geriatric Hospital 05/09/08 Class B
Point Loma Convalescent Hosp. 03/10/08 Class B
Ventura County
Brighton Gardens of Camirillo. 4/16/08. 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.

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A jury in Santa Ana awarded the family of Mary Adams $2 million after the 104-year-old was neglected in a Laguna Hills nursing home. The jury awarded $1 million for the Villa Valencia Health Care’s negligence, and another $1 million in punitive damages.

Juror Rory Paster, a 41-year-old engineering analyst who lives in Huntington Beach, said the jury wanted to “send a message that the company should do a better job of treating patients.”

According to reports, Adams admitted herself into the nursing home after suffering a fractured leg. Shortly after admission, Adams developed pressure sores on her heels, which were ignored, and not adequately treated. As a result, she contracted sepsis, and died about two months after her admission.

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Nursing Home malpractice comes in many forms, and has many names. Some call it nursing home abuse or neglect, others elder abuse, but whatever the name, it’s increasingly becoming a problem in the United States. And it’s not just nursing homes. Residential facilities and home health care providers can commit malpractice as well.

Walton Law Firm LLP has represented victims of nursing home malpractice for more than a decade, and has learned that nursing home malpractice can come in many forms. The most common being simple neglect – the failure to notice a change in the resident’s condition, whether it be the occurrence of bed sores, the development of dehydration or malnutrition, or an obvious injury that is not promptly addressed. The law defines neglect simply as the failure to provide care for a person’s physical and mental needs, and to keep them free from health and safety hazards.

More serious cases are those of intentional conduct such as physical abuse, or the intentional mistreatment of a resident, often in retaliation for some prior act. Or the failure to provide basic care because of issues related to under staffing, such as cases involving multiple falls because staff would not respond to call lights. These cases can fairly be described not as just malpractice, but a conscious decision on the part of the nursing facility to expose residents to the risk of harm.

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Yesterday the Bush Administration announced that it will create a nursing home rating system by the end of the year. The criteria for ratings has not yet been established, but will likely be a combination of state and federal inspection reports, staffing reports, and resident and family satisfaction surveys. The ratings would be placed on a government website.

“The fact a home has a lower rating will likely put them on the path to improvement,” said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services. “I don’t think we’re going to see many people who are very anxious to put a loved one in a one-star home.”

Those looking for information about California nursing homes already have a few options when looking at prospective homes. The California Advocates for Nursing Home Reform have a nursing home guide resource, and the California Healthcare Foundation has its own rating system. Both use the government surveys and staffing reports as a basis for the rankings, so the accuracy of the ratings is based primarily on the government’s information, which can be notoriously unreliable.

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A nursing home in Anaheim has received a $50,000 fine in the choking death of a resident. The resident, a brain injured man in his forties who had swallowing difficulty, choked on a piece of burrito.

According to reports, a caregiver was preparing the man’s meal at Parkview Healthcare Center when he reached for the burrito and put it in his mouth. When he began choking, the Heimlich maneuver was attempted but failed. Caregivers were then instructed to begin CPR, but before doing so, looked in the resident’s file to determine to see of there was a DNR (do not resuscitate) order. There was.

A doubtful nursing then called the man’s sister, telling her “your bother is turning black, do you want him revived?” When the sister responded “yes.” The DNR order was wrong. CPR was started. The man was pronounced dead approximately 30 minutes later. The fine was issued due to the nursing facility’s failure to provide “prompt emergency medical care” as requested by the resident.

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The U.S. Department of Justice is stepping up efforts to reduce nursing home mistreatment of elders through its Nursing Home Iniative. The iniative focuses on improving enforcement of existing laws, training, attention to medical forensic issues, and increasing the use of reliable criminal background checks.

Through its Elder Justice program, the DOJ is also increasing the enforcement of civil and criminal penalties against nursing facilities and others whose mistreatment results in the serious injury or death of elderly residents. It has also created State Working Groups to improve the coordination of federal, state, and local law enforcement in cases of health care fraud.

For more information, visit the DOJ’s website here.

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