Articles Posted in San Diego Nursing Home

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The Fallbrook Hospital District Skilled Nursing Facility was fined $90,000 by the California Department of Health in a case involving the fall and subsequent death of a resident. The citation was the most severe of its kind arising from inadequate care leading to the death of the resident. Although the resident was known to have a high risk for falling, the Fallbrook nursing home failed to take adequate measures to prevent the fall. The resident fell, broke his leg, and died four days later as a result of complications from the surgery to repair his leg.

The Walton Law Firm successfully prosecutes cases involving injuries caused by falls in the custodial care setting. If you have questions about falls, please submit your confidential question online, or call Walton Law Firm for a free consultation. We can be reached toll free at (866) 607-1325 or locally at (760) 607-1325

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At the end of last week, a Medicare rate adjustment that cuts $16 billion in nursing home funding went into effect. That cut, combined with state cuts, is creating conditions that are likely to put nursing homes in a state of crisis. In fact, the president of the American Health Care Association is predicting the nursing facilities will close their doors.

Already numerous nursing homes have closed their doors because of money problems, and many others have reduced staffing, creating conditions for substandard care. The crisis could not come a worse time, as baby boomers steamroll toward retirement and the need for skilled nursing care. Just last year U.S. nursing homes housed 1.85 million people, about 100,000 more than the previous year.

In Griswold, Conn., the community’s only nursing home shut down earlier this year because of rising costs and an inability to pay for $4.9 million in needed renovations for the 90-bed facility.”A 92-year-old woman was screaming and crying as she was loaded into the ambulance, saying ‘This is my home,'” Griswold First Selectman Philip Anthony said. His 88-year-old mother was a resident of the same home at the time.

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On a fairly regular basis I get telephone calls asking for a recommendation to a “good” nursing home or assisted living facility. I have to refrain from answering, because though I have brought legal actions against many nursing homes for abuse and neglect, I also know there are plenty of homes out there that can provide good care. I just don’t know who they are.

Today I met with someone who does. Lise Marquis, with A Place For Mom (www.aplaceformom.com), explained to me all the considerations in finding the right placement for an elderly loved one. A Place for Mom provides consultations for senior housing and care options, and has literally hundreds of options including skilled nursing facilities, assisted living, Alzheimer’s and dementia care, respite care, and board and care homes. And get this, the service is free.

In addition to providing options for housing, Lise can also provide resources for financing, therapy services, and legal services if those aspects of care are needed.

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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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State investigators issued a $100,000 fine to nursing home Aviara Healthcare Center in Encinitas after finding that a resident’s death was caused by neglect. The resident died of blunt force trauma after a fall.

According to reports, the resident was at the nursing home to rehabilitate a broken hip, and suffered a fall on May 9 when trying to get out of bed. The following morning at 3 a.m., the resident got out of bed and stumbled into the hallway. A nurse saw him grab onto a large Hoyer lift (a large mechanical lift), which toppled over on top of the resident. The lift struck him in the head, causing a deep cut and a severe brain injury. He died three days later.

Investigators concluded that Aviara Healthcare was negligent for storing the large mechanical lift in the hallway outside the resident’s rooms, and received statements from several employees who stated that the lift was supposed to be stored elsewhere. As a result, a Class AA citation was issued.

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A report published by the National Nursing Home Survey finds that between 1999 and 2004 the number of nursing home beds and nursing home residents declined in the United States. The number of nursing home beds dropped more than 10%, or 200,000 beds, and there are approximately 100,000 fewer nursing home residents.

The survey also found that more nursing facilities are certified for both Medicare and Medicaid, and that the vast majority of caregivers were not licensed nurses, but Certified Nursing Assistants. Also, it was found that a small fraction of nursing home residents are independent, and need no help with their activities of daily living, which a slight majority, 51.1%, needed assistance with all daily activities.

To read the entire survey, click here. (.pdf)

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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
Antelope Valley Healthcare 3/04/09 Class B
Arbor View Rehabilitation 3/11/09 Class B
Burbank Healthcare and Rehab 3/04/09 Class B
Casa Bonita Convalescent 3/31/09 Class AA
Chandler Convalescent 2/04/09 Class B
Country Villa Broadway 3/02/09 Class B
Emeritas at San Dimas 3/30/09 Class A
Lutheran Health Facility 3/04/09 Class B
Mid-Wilshire Health Care Center 2/02/09 Class B
Royal Oaks Convalescentr 3/13/09 Class B
Tarzana Health and Rehab 4/07/09 Class B
Windsor Terrace Healthcare 2/09/09 Class B
Orange County
Coastal Communities Hospital 03/17/09 Class B
Country Villa Laguna Hills 03/03/09 Class B
Fountain Care Center of Orange 4/07/09 Class B
Sunbridge Care and Rehabilitation 1/21/09 Class A
Riverside County
Hemet Valley Healthcare Center 2/10/09 Class A
Hemet Valley Medical Center 12/04/08 Class A
Plymouth Tower 1/13/09 Class B
San Diego County
Care With Dignity Convalescent 2/11/09 Class B
Escondido Care Center 02/25/09 Class AA
Fallbrook Hosp. Dist. Skilled Nursing 3/02/09 Class B
La Paloma Healthcare Center 3/04/09 Class B
Remington Club Heatlh Center 3/18/09 Class B
Vista Knoll Specialized Care 3/04/09 Class B
Ventura County
Brighton Gardens of Camarillo 3/09/09 Class B, WMO
Camarillo Healthcare Center 3/09/09 Class B
Country Villa Oxnard 10/30/08 Class B
Fillmore Convalescent 4/03/09. Class B
Twin Pines Healthcare 3/09/09. Class B
Santa Paula Healthcare 3/17/09 Class B, A, A, A

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 conservatorship is a protective court proceeding which is held in the Probate Division of the San Diego Superior Court. A general conservatorship can be a critical vehicle used to assist someone who has suffered a debilitating accident or injury that impairs their ability to care for themselves physically or financially. A conservatorship proceeding can also become necessary to protect an elder who is losing his or her ability to care for themselves properly or who is subject to undue influence.

In a conservatorship of the person, the court-appointed conservator manages the personal care of a person who cannot properly provide for his or her personal needs regarding physical health, medical care, food, clothing or shelter. The conservator may also decide where the conservatee lives, and must ensure the environment selected is the least restrictive choice available.

In a conservatorship of the estate, the court-appointed conservator manages the financial affairs of a person who is substantially unable to manage his or her financial resources, or to resist fraud or undue influence. Depending on the particular individual’s needs, the court may grant a conservatorship of the person, the estate, or both.

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A study of bed sore rates in nursing homes with a high concentration of Hispanic residents found that Hispanics were more likely to have bed sores (or pressure ulcers) than nursing homes with less Hispanic patients. The researchers looked at two data sources, the Minimum Data Set, federally mandated health evaluations required for every patient, and the Oscar database, a collection of health information of nursing home residents.

“A systemic evaluation of the difference in the process of care between high- and low-quality nursing homes is warranted in order to reduce nursing home disparities,” said Michael Gerardo, adjunct assistant professor at Brown University.

Only nursing home residents living in free-standing nursing facilities in Arizona, California, Colorado, New Mexico, and Texas were included in the study.

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Escondido Nursing Center received the state’s most severe citation – a AA – after the choking death of an elderly resident. According to reports, the 180-bed facility failed to modify the resident’s nutrition plan after his physician placed him on a special diet because of chewing and swallowing difficulties. During lunch on November 30, 2008, the resident suffocated when food got stuck in his wind pile. He had been given beef and carrots.

Class AA citations are relatively rare in California, with only about 20 being issued annually. In our view, this isn’t enough. As nursing home abuse and neglect attorneys, we have investigated numerous horrendous cases of neglect similar to this one (actually, many are worse), where an investigation is completed by the California Department of Public Health and no citation is issued. This may be a good sign that the new leadership at CDPH is changing the culture and encouraging the department to be more willing to enforce California state law as the people expect.

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