Articles Posted in Nursing Home Abuse and Neglect

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The North County Times had a good column on the cold reality that elder abuse or neglect can happen anywhere. Susan Reichel, CEO of Advanced Home Health Services in San Diego says that an estimated 2 million elderly Americans are victims of elder abuse, whether its physical, mental, emotional, or financial, and it can occur in the home or at a nursing facility.

We, of course, know this. At this law firm, we take legal action against nursing homes and residential care facilities for abuse or neglect all the time. But it’s always worth reminding people that such abuse cases are real and all around us. Remarkably, it is estimated that 84 percent of elder abuse cases go unreported.

The author makes a list of clues to look out for that might be signs of abuse or neglect, and we though it would be helpful to list them here.

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Last Friday, Governor Arnold Schwarzenegger signed Assembly bill 392, which provides funding for California’s long-term care ombudsman programs. The bill does not restore entirely the cuts that were made last year, but the $1.6 million appropriation to approximately 36 agencies throughout the state will provide sorely needed money to programs that, only weeks ago, were on the brink of dissolution.

“This legislation could make the difference between life and death for nursing home patients facing abuse or neglect. Now patients and their families who depend on the Ombudsman to monitor facilities and investigate key complaints can rest a little easier,” said California Assembly member Mike Feuer.

Last year’s cuts were exemplified in several high profile cases of nursing home abuse and neglect. In June 2009, a nursing home facility owner and a caregiver were arrested on suspicion of criminal abuse and neglect when a resident suffered from pressure sores so severe they led to a fatal infection.

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Researchers analyzing 82 different studies on nursing home care found that nursing homes that are run as not-for-profit businesses offer better care than their for-profit counterparts. In the United States, less that one-third of all nursing homes are non-profit.

The 82 studies were from both the U.S. and Canada, and were completed between 1965 and 1983. Of the studies, 40 showed that non-profit nursing homes provided much better care than for-profits, while only three of the studies found that for-profit nursing homes provided better care. The remainder had mixed findings.

Importantly, the study suggested that non-profit nursing facilities did better in four important quality measures: higher quality staffing, lower rates of pressure ulcers and bed sores, less use of physical restraints, and fewer deficiencies cited by government regulators. Staffing issues, bed sores, and government investigations represent by far the basis for most of the nursing home abuse and neglect litigation in this law firm.

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The Orange County nursing home Tustin Care Center has received a citation and a fine of $50,000 by the California Department of Public Health after a resident choked to death during lunch. A state investigation concluded that the nursing home’s failure to adequately assess the patient’s growing inability to eat as the cause of death.

According to the state report, the elderly man had been growing weaker over time, but that the nursing facility allowed him to continue to eat regular meals. In March, while eating lunch with his wife, who was also a resident at the Tustin facility, when he had difficulty breathing. As the patient struggled to breath, an attendant was called over, who tried to clear the airway.

The man died at a local hospital later that same day, and an examination found that food was completely blocking his airway.

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As California starts to overhaul the regulation of its 350,000 registered nurses, one of the nursing board’s most promoted and trouble programs is under the microscope. The nursing drug diversion program, which seeks to help nurses maintain their licenses while they kick addiction to drugs, has apparently not been the success the nursing board would like the public to believe.

An investigation by the Los Angeles Times and ProPublica discovered several examples of nurses in the drug diversion program who practiced nursing while intoxicated, stole drugs from bedridden patients, and committed fraud to prevent from being caught.

Most troubling is that since the program was started in 1985, more than half the nurses who entered the program were unable to finish it and numerous nurses who failed the program were deemed to be “public safety threats.” Yet despite the identification of incorrigible nurses, several continued to work after the findings were made.

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The great recession hasn’t impacted everyone negatively. While the salaries and compensation for nurses has remained stagnant, the salaries for nursing home administrators have climbed to its highest rate in four years.

According to a study by the Nursing Home Salary and Benefits Report from Hospital & Healthcare Compensation Service, the average salary of a nursing home administrator rose by an average of 4.8% in 2009. The national average now hovers around $89,000 for administrators of nursing homes of all sizes, including not-for-profit facilities.

The study took samples from more than 10,000 nursing homes across the United States.

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The California State Assembly voted overwhelmingly to approve Assembly Bill 392, which would immediately restore $1.6 million to Long-Term Care Ombudsman programs throughout the state. Much of the funding to the programs was cut last year when Gov. Schwarzenegger vetoed the Ombudsman funding request.

In June 2009, a nursing home owner was arrested on allegations of criminal abuse and neglect, when a resident of his facility was so severely neglect that pressure sores went untreated and led to a fatal infection. Numerous nursing homes throughout the state have received citations for failing to provide adequate care of residents. Without an Ombudsman program, it is difficult to monitor the care the residents of these facilities.

“We need to take every step we can to protect seniors who may be at serious risk of abuse or exploitation,” said Assembly member Mike Feuer (D-Los Angeles), who authored the bill. “The funds provided to Ombudsman programs in AB 392 fill this important need during the next year. Isolated and vulnerable residents of nursing homes and assisted living facilities have nowhere else to turn, and their lives depend upon these programs being restored immediately.”

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Elder abuse cases are rarely reported, and even more rarely prosecuted. “Elder abuse cases, for whatever inappropriate reason, are not considered as severe,” said Riverside County District Attorney Rod Pacheco.

The reasons for the low reporting and prosecuting are varied. There is the embarrassment of being a victim, and in many cases – up to two-thirds – the elderly victim knows the abuser. But there is also the problem of ageism; the failure to take the matter seriously because the victim is elderly.

And it’s not just the public that needs educating about elder abuse and neglect, but law enforcement as well. Riverside County has a special team dedicated to elder abuse cases, and it sees the ageism first hand. “They’re old. They didn’t have to live anyway,” are the types of excuses heard by Tristan Svare, a San Bernardino deputy district attorney.

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It’s been almost six months since Nursing Home Compare was launched, and all of the nations 15,600 nursing homes were listed and rated by the U.S. government. The reviews are in, and it’s no blockbuster, but it isn’t a flop.

For consumers, it’s been mostly a good thing. It is the most complete nursing home rating website, which provides information about nursing staffing, state inspections, allegations of neglect. But some consumer groups want more details included about inspection results, and how staffing hours is calculated. Just counting workers, they say, is no indicator of the quality of care.

The nursing home industry, which tried to delay the website’s rollout, says the grading system used by the site is misleading. Just because an allegation of neglect or abuse is made, it doesn’t mean it has been substantiated.

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One nurse twisted a patient’s jaw until he screamed. Another grabbed an elderly man by the shoulders and slammed him against a mattress. Our 70-year-old client was punched in the face by an angry nurse while giving our client a bath.

Charles Ornstein of the LA Times is out with an article today about problem nurses. He highlights a very troubling fact: It sometimes takes years for a formal complaint against a nurse to be addressed by the California Board of Registered Nursing. As Ornstein writes:

It’s a high-stakes gamble that no one will be hurt as nurses with histories of drug abuse, negligence, violence and incompetence continue to provide care across the state. While the inquiries drag on, many nurses maintain spotless records. New employers and patients have no way of knowing the risks.

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