Articles Posted in Southern California Elder Abuse

All licensed nursing homes in California are licensed and certified by the California Department of Public Health, which conducts an annual inspection of every licensed skilled nursing facility in the state. In addition, the DPH is charged with the duty to investigate complaints of neglect or abuse, and issue the results of its investigation. Here is some general information about making a complaint against a nursing home.

First, who can make a complaint? Under California law, any person can make a complaint about a nursing home; it does not just have to be the resident, family member, or responsible party. Complaints may be made anonymously.

When is a good time to make a complaint? A complaint should be made whenever one considers the treatment problems to be serious enough to report. It is usually a good idea to express your complaints to the facility first, but if you feel like you’re not being taken seriously, call DPH.

In their ongoing series on nursing oversight in the State of California, Tracy Weber and Charles Ornstein of ProPublica are out with another story about California’s shortcomings in regulating healthcare professionals. Weber and Ornstein reveal that the national database that tracks dangerous or incompetent caregivers is missing serious disciplinary actions against “what are probably thousands” of health care providers. The revelations apparently surprised federal health officials, who just last month proclaimed that “no data is missing.”

For almost twenty years the federal government has kept a database of disciplinary actions against doctors and dentist, and in 1999 individual state boards were required to include in the database reports on all other healthcare professional, including nurses, whose licenses were restricted or revoked. In California, however, not all penalized caregivers were included in the federal database. For example, California has formally disciplined 84 psychiatric technicians over the last two years, yet the federal database does not contain a single report of discipline against a psychiatric technician in the State of California.

The dangers of an incomplete database are obvious, as Dr. Sidney M. Wolfe of the Public Citizen’s Health Research Group observed, prospective employers of health care professions could be given “a false sense of security that somebody who may be really dangerous isn’t, because their name isn’t there.”

The New York Times is out with an article about lack of oversight given to the more than 400 long-term acute care hospitals that operate in the United States. These hospitals, most of which operate as for-profit organizations, are supposed to provide care for individuals that are too sick for traditional nursing homes, but too stable to require regular hospitalization. According to the article, long-term care hospitals were much more likely to be cited for serious violations of Medicare rules than regular hospitals, and had a higher incidence of bedsores and infections.

While the care might be questionable, the no one will question the profitability of these health care providers. In 2007, the profit-margins on long-term care hospitals was 6 percent on Medicare patients, which regular acute-care hospitals lost an average of 6 percent on Medicare patients. How does that happen? In a presentation last month by Select Medical, an owner of several long-term care hospitals, to its investors, it revealed that it maintains its profits by monitoring staffing and lowering supply costs.

Those of us who represent victims of neglect in long-term care facilities know that “monitoring staffing” is another way of saying that it keeps staffing levels at the lowest numbers allowable by law. That usually means a lower quality of care. As for Select Medical, this approach is victimizing patients.

The nursing home roommate from hell. A former San Diego nursing home resident was sentenced to 19 years in jail yesterday for setting a series of fires at two local nursing homes while she was a resident. According to an investigation, Mary Wilson tried to kill her nursing home roommate by setting her bed on fire while she slept. In another incident, Wilson threatened a resident with a knife.

The first incident occurred in January of 2009, when Wilson was a resident of the San Diego skilled nursing facility El Dorado Care Center in El Cajon. She was placed in a room with two roommates, both of whom were on oxygen and confined to their beds. In the middle of the night, Wilson got out of her bed and set the mattress on fire of one of her roommates. The fire alarm was triggered, and caregivers were able to extinguish the flame before any injuries occurred.

In May, Wilson was transferred to the assisted living center Golden Paradise Senior Living in National City. Shortly after her arrival, she set fire to trash cans and in the library. Luckily, there were no injuries.

Nursing home abuse and neglect lawyers in California often lament the state’s weak enforcement of bad nursing homes. The California Department of Public Health, due primarily to inadequate funding, rarely provides the strong oversight of California’s 1,200 or so licensed skilled nursing facilities. As a result, bad nursing homes operate with relative impunity, and those who screw up rarely suffer the consequences.

Apparently California is not alone. In Connecticut, the director of the state’s Department of Public Health said his unit is dangerously understaffed. He has only four investigators to oversee the state’s 231 certified nursing facilities, and told the Norwich Bulletin that if he had 10 more, he would have a lot more cases.

State Sen. Edith Prague has apparently had enough. She is set to re-introduce a bill that would make it easier to hold the owners of nursing homes criminally responsible for abuse and neglect of patients in their facilities. Under Prague’s bill, the state’s DPH would be required to include a notice in nursing home applications telling owners they could be held criminally liable for patient neglect by employees, including for things such as inadequate staffing. “You can’t sue the state, but the nursing home owners who cut back on staffing I feel should be held responsible,” Prague said.

U.S. News and World Report, famous for its “best” lists, is out with a ranking of the country’s best nursing homes. There are approximately 16,000 individuals living in U.S. nursing homes, and approximately 3.2 million will spend time in one each year. Here at Walton Law Firm we get asked all the time to recommend nursing homes, but rarely can provide a good answer. In our experience, the best guarantor of good care is an attentive family who visits frequently.

Here is a list of the top 25 Southern California nursing homes as ranked as the U.S. News and World Report ranks as the best:

1. Rady Children’s Hospital Bernardo Center, San Diego

This story is flat-out disturbing, and started with a concern we have heard many times from the families of our nursing home abuse clients. It began with Phyllis Peters could not wake up her 97-year-old mother, who was residing in Kern Valley Nursing Home. When she complained to Gwen Hughes, the nursing home’s director, Hughes would “chemically restrain” the patient by giving her powerful anti-psychotic drugs to shut her up. Hughes did this to other residents in the nursing home, and three of them died.

In a report from the California Attorney General, Hughes ordered one patient drugged because she “glared” at her. Another was given high doses of an anti-psychotic drug for throwing a carton of milk. Several residents became severely malnourished, and were left in bed drooling and emaciated.

“In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet,” said AG Jerry Brown.

According to new research from Brown University, elderly Hispanics are more likely to live in inferior nursing homes than their white counterparts.

In an article out in the January 10 edition of Health Affairs, a team of researchers takes the first comprehensive look at the types of nursing facilities Hispanic elderly live in, and how the care at those homes compares to homes that house a primarily white patient population. According to the study, the disparity is sharp.

“The most shocking finding is the pervasiveness of disparities in nursing home care that are primarily white, compared to nursing homes that are a mix of whites and Hispanic residences,” said Mary Fennell, professor of sociology and community health at Brown.

A Ventura nursing home called Fillmore Convalescent Center, its owner, and one of its employees were hit with a $7.75 million verdict yesterday after a jury found them liable for elder abuse. It has to be one of the largest verdicts in California in a case involving nursing home abuse or neglect.

The facts are egregious. In 2006, the family of 71-year-old Maria Arellano, a stroke victim who was also non-verbal, began to notice suspicious bruising. They complained to the nursing home administration, but it failed to look into it. The family then placed a hidden camera in Ms. Arellano’s room, which caught caregiver Monica Garcia slapping Arellano, pulling her hair, bending her fingers, and treating her violently. When the tape was revealed, Garcia was charged with criminal acts, and the family brought an elder abuse lawsuit against the nursing home.

The lawyer for Arellano, Greg Johnson, must have done an excellent job. He told the Ventura County Star that he offered to settle the case for $500,000, but was rebuffed. The nursing home, through its attorney Tom Beach, never offered a dime to resolve the case. “There was a lot of arrogance,” said Johnson.

In their ongoing investigation into California nursing, Tracy Weber and Charles Ornstein of ProPublica are out with an article on temporary nursing agencies being a haven for unfit nurses. Temp nursing agencies are used frequently by local hospitals and nursing homes to fill nursing positions that have been vacated for some reason; usually for day or two, but sometimes open-ended.

In its investigation, ProPublica found numerous instances in which the agencies, desperate to find certified nurses, failed to perform background checks or ignored warnings from hospitals about weak nurses in order to fill nursing orders. It is a profitable undertaking; the temporary nursing industry is a $4 billion industry.

Some of the other ProPublica findings were startling:

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