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

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Many Americans have heard that long-term care can be extremely expensive and that it’s important to begin saving, or alternately to invest in long-term care insurance, as soon as possible. But is long-term care insurance really all it’s said to be? Are there other options for elder care? A recent PBS interview with economics professor Lewis Mandell suggests that simply saving money, rather than investing in these insurance plans, may ultimately be a larger help to the elderly.

What is Long-Term Care Insurance?

The U.S. Department of Health and Human Services (HHS) explains that long-term care insurance is special in that it’s “designed to cover long-term services and supports, including personal and custodial care in a variety of settings such as your home, a community organization, or other facility.” These policies work by reimbursing policyholders with a pre-selected daily amount “for services to assist them with activities of daily living such as bathing, dressing, or eating.”

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Over the last year, California assisted living facilities have been under intense scrutiny by elder care advocates and the public alike. Just last month, California legislators appeared at a press conference in Sacramento to unveil plans for new bills that will encourage assisted living facility reforms throughout the state. The reforms will come “as part of the RCFE Reform Act of 2014,” according to a press release from the California Advocates for Nursing Home Reform (CANHR).

As you might recall, an RCFE is a residential care facility for the elderly. In California, RCFEs, also known as assisted living facilities, are responsible for a lower level of care than a nursing home, but they must still be licensed with the state. According to the Department of Social Services, RCFEs can “provide care, supervision and assistance with activities of daily living, such as bathing and grooming.” They can also “provide incidental medical services under special care plans,” but they can’t administer significant medical treatment or care.

The reforms may be able to curb certain acts of elder abuse in our state, but it’s still important to keep an eye out for signs of nursing home abuse and neglect if you have an elderly loved one in a facility.

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What happens when elderly adults spend some time in the hospital but aren’t officially admitted? In these situations, patients are typically classified as simply being under observation. This “observation only” status can limit older adults’ chances for Medicare nursing home coverage once they’re discharged from the hospital, according to a recent article in the New York Times. Can this lead to elder abuse conditions? And how is this happening? In order to be eligible for certain Medicare benefits, an elderly patient “must spend three consecutive midnights in the hospital—not counting the day of discharge—as an admitted patient in order to qualify for subsequent nursing-home coverage.”

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More than one year ago, the California Hospital Association (CHA) recognized the problems that arise because of the “observation status” that many older adults end up with during a hospital visit. The CHA reported on an amicus brief filed by the American Hospital Association (AHA) in connection with a federal lawsuit in which Medicare beneficiaries contested the use of an “observation status” to later deny nursing-home coverage. This past December, AARP released a report that argued certain medical facilities intentionally place older adults under observation—as opposed to admitting them—for Medicare purposes, according to California Healthline. As you can see, this is an issue that’s relevant in California and across the country. What are the key issues at stake, and how can elderly citizens receive the care they need?

What Does “Under Observation” Really Mean?

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It’s clear that many hospice centers have become part of a profit-seeking industry in the United States. Indeed, the recent article in the Washington Post concerning illegitimate marketing and hospice overuse may be plaguing many parts of the country. But what about seniors who are admitted to hospice care and then discharged without getting any better? Is our country in need of elder care reform? An article in the New York Times suggests that there may be another significant problem with the hospice industry that lies more with the Medicare Hospice Benefit of 1983.

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Do you have questions about caring for an elderly loved one? The experienced nursing home abuse lawyers at the Walton Law Firm can speak to you today.

Elements of the Medicare Hospice Benefit

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Profiting from Bad Hospice Ethics

Last week, we discussed a recent phenomenon in the hospice care industry that’s quickly becoming an elder abuse concern. Specifically, hospice—a form of care designed to allow “patients to die at home or in other familiar surroundings,” according to an article in the Washington Post—has turned into a financially lucrative business. But is it an ethical one? Are hospice companies acting outside the boundaries of the law? And is it possible to take legal action against hospice chains that recruit patients who aren’t suffering from a terminal illness?

Old%20Dying%20Woman.jpgFirst, it’s important to have a clear idea about why hospices are bringing in relatively healthy older adults, and how these companies are profiting from non-terminal patients. How did this start to happen? In short, many hospice care centers have begun recruiting patients with aggressive marketing tactics, and many of those patients aren’t terminal. It’s in the financial interest of a hospice chain to “find patients well before death,” the Washington Post reported. And the reason is simple: “Medicare pays a hospice about $150 a day per patient for routine care, regardless of whether the company sends a nurse or any other worker out that day. That means healthier patients, who generally need less help and live longer, yield more profits.”

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In California, people who are in need of custodial care, whether it’s due to age or some other disability, often seek out care homes licensed by the State of California. To be licensed, a home or facility must follow stringent state regulations that cover all aspects of care and safety, including in the event of fire.homefire.jpg

During the early hours of this morning, a fire broke out a Mary’s Home in Santa Ana, a residential care facility for the developmentally disabled. According to reports, a caregiver was making breakfast when a smoke alarm was first heard. Outside, a neighbor also heard the alarm and saw smoke, and ran to a window and saw flames and a mattress on fire. Within seconds the room was engulfed in flames and several people were trapped inside.

Orange County firefighters responded quickly to the blaze, but not soon enough to save the lives of two disabled women who apparently died in their respective bedrooms. A 71-year-old caregiver was seriously injured in the fire, but expected to survive. The house was home to six disabled women in their 30s through 60s.

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Have you been urged to place your elderly parent in hospice care despite the fact that he or she is not terminally ill? Hospice care is intended for patients who are terminally ill and for whom there is no cure. So why are healthy older adults ending up in hospice? A recent article in the Washington Post revealed that this phenomenon might be a larger problem than we’d like to think. Indeed, over the 2000s, the newspaper reported that the “number of ‘hospice survivors’ in the United States has risen dramatically.” What’s going on? According to the article, “hospice companies earn more by recruiting patients who aren’t actually dying,” since “healthier patients are more profitable because they require fewer visits and stay enrolled longer.”

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If you have been pressured to move a parent into hospice care, your elderly loved one might not receive the kind of treatment she or he needs. For-profit companies shouldn’t be allowed to take advantage of older adults. Indeed, we might think of these actions as another form of elder abuse. It’s important to speak to an experienced elder law attorney about your options.

Hospice Discharge Statistics

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Recent news reports from U-T San Diego have emphasized serious elder care neglect issues in Southern California. From fatal medical errors to clear-cut cases of nursing home abuse, many facilities in the San Diego area don’t appear to be up to snuff. Yet, there’s even more troubling news. According to a recent article in U-T San Diego, it looks as if there may be a serious problem with enforcement. Even when the state steps in and fines these senior homes, the facilities aren’t paying up. The article succinctly explained, “a key mechanism in getting assisted-living homes to live up to their commitment to take proper care of seniors is broken.”

Old%20Man%20Credit.jpgIf residential facilities are not held to the fines levied against them by the California Department of Social Services when they’re found to have committed elder abuse or elder neglect, what is to stop these care homes from behaving negligently? It can be difficult to know whether a loved one has been subject to nursing home abuse and neglect, but it’s always a good idea to speak to an elder justice advocate. If you believe an older adult has been the victim of elder neglect, you should contact an experienced nursing home abuse attorney.

Negligent Fine Collection by the Department of Social Services?

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About a month ago, the New York Daily News reported that fourteen nursing home residents at Valley Manor Community Care Home, also called Valley Springs Manor, were abandoned in “filthy and unsafe” conditions. According to the article, some of the residents at this Castro Valley, California facility were bedridden, while others were ill and simply required significant care. Reporters from NBC Bay Area referred to the situation as a “botched closure,” as the California Department of Social Services had closed the nursing facility days before but hadn’t accounted for the safety of these residents. At the time, these social services officials closed nursing home “because of deplorable conditions.”

Sheriff%27s%20Badge.jpgWhen we think about transitioning an elderly loved one into a nursing home or an assisted-living facility, we expect that the facility will provide care and won’t engage in acts of nursing home abuse or neglect. However, nursing home abuse occurs more often than we’d like to think. If you’re concerned about a loved one’s safety or care, a California elder justice advocate can discuss your case with you today.

Details of the Nursing Home Shut Down and Resident Abandonment

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Sometimes we forget that nursing home abuse isn’t always physical, and it may not be obvious. Particularly with older adults, abuse can be verbal, and it can wound seniors both emotionally and psychologically. A recent study conducted by researchers at Northeastern University emphasized that older adults typically aren’t openly willing to discuss their experiences with abuse, so the study provided elderly participants with more privacy when responding to questions about mental and physical anguish. According to an article in the New York Times, the study revealed that more than one-third of seniors have suffered physical abuse, usually at the hands of their caregivers.

Yelling.jpgIt’s no secret that elder abuse and neglect is a serious issue in California and throughout the country. Indeed, over the past few months we’ve mentioned that PBS Frontline and other national news outlets, as well as our own local U-T San Diego, have attempted to raise awareness about nursing home abuse and its serious consequences. Are you concerned that an elderly parent or loved one has been abused in a nursing home or assisted-living facility? It is never too early to speak to an experienced California nursing home abuse lawyer.

Studying “Words that Wound” Older Adults

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