Articles Posted in Orange County Nursing Home

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799px-Alcohol_bottles_photographed_while_drunkHow broad is the term nursing home neglect? For instance, when a senior has a problem with drug or alcohol abuse and lives in a nursing home or an assisted-living facility in Southern California, does the facility have a duty to prevent the senior from obtaining potentially harmful substances? And if the facility knows about a history of drug or alcohol abuse and does not take precautions to limit a senior resident’s access to alcohol or prescription drugs, can the nursing home be responsible for injuries that occur? According to a fact sheet from the National Council on Alcoholism and Drug Dependence (NCADD), it can be difficult to recognize signs and symptoms of substance abuse among older adults.

Should we be able to expect that facilities will look into signs and symptoms of substance abuse among elderly residents? And if a facility in San Diego already knows that one of its residents has a history of drug or alcohol abuse, what must it do differently in other to avoid allegations of nursing home negligence?

Difficulty Identifying Senior Residents with Substance Abuse Problems

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An 81-year-old nursing home resident beat his 94-year-old roommate to death with a closet rod in their Laguna Hills nursing home. Sheriff’s have arrested William McDougall of Mission Viejo for causing the death, and he has been booked for murder. The victim, Manh Van Nguyen of Laguna Woods, was pronounced dead upon arrival to Saddleback Memorial Hospital.

l9oh7z-l9oh6tmcdougall.jpg The motive in the killing is unclear. Both men were residents at Palm Terrace Healthcare and Rehabilitation Center, a licensed skilled nursing facility in Laguna Hills. (More info about the facility here) “What prompted the attack is still under investigation. Obviously, this is very unusual,” sheriff’s spokesperson Jim Amormino told the media. Staff at the nursing home have apparently told sheriff’s investigators that there no prior conflicts between McDougall and Nguyen.

What causes violence such as this in the nursing home? It could be a number of things. First, it is not uncommon for residents with memory impairment such as Alzheimer’s disease to act aggressively toward caregivers and others. Our law firm has represented victims of peer-on-peer abuse in the past. Another possibility is medications. What medications was McDougall on (or not on) that might have contributed to this offense. And, of course, maybe McDougall is just a violent person. No doubt all of this will be uncovered in the criminal investigation, which is just starting.

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This story makes one wonder what would happen if a hidden camera sting was done in every nursing home. The attorney general of New York placed a hidden camera in a single room of a long-term care facility, which resulted in an indictment against nine nurses, the nursing home, for a whopping 169 separate crimes.

The indictment filed in the case alleges 57 instances of neglect during a three-month period in 2009. With the family’s permission, a hidden camera was placed in the room of a 53-year-old resident who suffers from multiple sclerosis and other mental and physical illnesses. The video revealed that the nurses failed, on several occasions, to turn the patient regularly as required, failed to medicate as needed, treat his pressure ulcers, or even change the resident’s clothing. Of course, in the medical chart, these nurses stated that all this care had been provided. The fraudulent medical charting resulted in further criminal charges.

In interesting footnote to the story, when the alleged abuse revealed, several people came to The Record newspaper to tell their stories of abuse or neglect inside the facility, including unanswered call lights and untreated infections and bed sores.

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A resident of St. Edna skilled nursing facility in Santa Ana (a Covenant Care facility) was awarded $3.1 million by an Orange County after the jury found that the nursing home failed to recognize that the resident was overdosing on morphine. The jury also found that the nursing home acted with malice or oppression, and will award punitive damages at a hearing next Tuesday.

St. Edna’s was among the many California nursing homes who received $880 million in Medi-Cal compensation from the state in a program that began in 2004, and was designed to promote care and avoid staffing deficiencies. Many homes that received the additional money still reduced staffing, despite profiting from the additional funds. Apparently St. Ednas was one of those homes.

In this case, Barbara Lefforge was admitted to St. Edna on Sept. 17, 2007, to rehabilitate from tendon repair surgery. Her surgeon mistakenly recommended 50 mg of morphine for pain instead of 50 mg of Demerol. That is a huge dose of morphine, which Lefforge’s attorney argued should have been promptly caught by the nursing home staff. According to reports, a nurse at the facility could not get the full does, so took 30 mg from an office emergency kit and gave it to Lefforge, who suffered an overdose, which itself went unnoticed by the staff. She suffered a major brain injury.

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California Watch is out with a disturbing report alleging that California nursing homes that received more than $880 million in additional taxpayer funds under a law designed to boost care, took the money did the opposite by cutting staff and wages. [“Nursing homes received millions while cutting staff, wages“] In its investigation, California Watch found 232 California nursing homes that either cut staffing, or paid lower wages to workers after receiving money from the state.

It appears that many of the nursing homes investigated used the state money to improve their financial health, not the health of its residents, and those that cut the most staff had, not surprisingly, more deficiencies issued by state inspectors than those facilities that did not cut staff.

“There was an implicit good faith agreement that things would get better … and that was broken,” state Sen. Elaine Alquist, D-Santa Clara, told California Watch. “It was broken for the people of California and for a very vulnerable population – those that need the greatest care and those that can’t advocate for themselves.”

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The heirs of an elderly nursing home resident have sued the nursing home for causing the death of their father Oliver Shrock. The lawsuit alleges that caregivers at Kindred Healthcare Center in Orange County ignored the family’s warnings that Shrock was at risk for falling, and failing to take appropriate fall precautions, such as using a bed alarm. On July 14, 2008, just two months after his admission into the facility, Shrock fell and struck his head. He died four days later.

The California Department of Public Health investigated the 77-year-old’s death and concluded that the resident’s death was caused by the nursing home’s negligent care. A AA citation was issued, and an $85,000 assessed.

According to the lawsuit, Shrock fell shortly after admission, and that while some fall interventions were taken, they were used sporadically. For example, a bed alarm was used on Shrock, but only occasionally. The visiting daughters would repeatedly after to remind the facility to use it. Sadly, on the day of the fall, the bed alarm was not in place. It was the day Shrock was going to go home.

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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 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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The California Department of Public Health has issued fines to two Orange County nursing homes after concluding that negligent nursing care lead to the deaths of two residents. Alamitos West Health Care Center in Los Alamitos was fined $100,000.00, and Huntington Valley Healthcare in Huntington Beach was fined $80,000.00.

Investigators found that Alamitos West failed to give an 82-year-old female resident adequate fluid, causing her to suffer dehydration and kidney failure. When the woman was finally transferred to a hospital, her dehydration had caused an altered mental status. The woman died a week later, on Christmas Day.

The case against Huntington Valley involved the failure to call 911 as a patient was dying. According to reports, the caregiver thought the resident did not want resuscitation if life saving treatments was needed, but the resident had actually stated in his chart “I Do Want C.P.R.” The resident died in the nursing home.

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