Shower headOver the past couple of years elder advocates have been paying a significant amount of attention to physical abuse and neglect at nursing homes in the San Diego area. It is important to remember that nursing home abuse can take many forms, including emotional and psychological abuse. According to a recent report from ABC 10 News, allegations of elder abuse at a Vista facility have resulted in an investigation by the San Diego County Sheriff’s Department. The article indicates that an employee at the LifeHOUSE Vista Healthcare Center has been “accused of using her cellphone to take footage of a patient getting in the shower, and then posting it on the internet.”

Elder Abuse Investigation in Vista

The elder abuse investigation in Vista got underway after someone who viewed the online video “took a screen grab” of it and sent it to ABC 10 News. The video was taken on Snapchat. According to the report, “it shows a partially nude woman from the shoulders up,” and there is an employee “standing behind her laughing.”

ScrollAccording to a recent article in the Contra Costa Times, California Governor Jerry Brown recently signed into law a bill that will impact licensing requirements for residential care facilities for the elderly (RCFEs). Specifically, the law will require applicants seeking a license to run an RCFE to “disclose prior ownership of any type of facility in any state.” With this information, elder justice advocates hope that California can prevent the opening of RCFEs by persons who have been linked to accusations of elder neglect or nursing home abuse around California and in other parts of the country.

History and Requirements of the New Law

The law began as AB 601, and it was written by Assemblywoman Susan Eggman. The law is aimed at establishing “specific suitability requirements for all licensing applications,” which involves the following:

As of July 1, 2015, owners of Residential Care Facilities for the Elderly (RCFEs) in California were required to have liability insurance in the event of elder neglect and other related injuries. The new law, which went into effect just this past summer, began as AB 1523, a bill that was sponsored by the Consumer Advocates for RCFE Reform (CARR). In the minds of many elder justice advocates, mandatory liability insurance for RCFEs represents one step toward safer care options for seniors in California. If we take a closer look at the history of the bill and the implications of mandatory liability insurance in our state, we can better understand how this new law may have an effect on incidents of nursing home abuse.

Background to AB 1523 and the Requirement of RCFE Insurance

Over the last couple of years, numerous advocates have voiced concern about the state of the assisted-living industry in California. Many reports about elder abuse and neglect appeared in The San Diego Union-Tribune, emphasizing the need for reform measures throughout the state. One of those reforms includes the law requiring liability insurance for RCFEs. As CARR explains in a press release about the new law taking effect, the advocacy group conducted extensive research into the affordability of mandatory insurance. In short, CARR found that “the average monthly cost to a small, six-bed facility would amount to approximately $50 per month per resident.” According to CARR, $50 per month for each resident of an RCFE is “a reasonable amount by any standard.”

file000441681066A recent report from U.S. News & World Report emphasized that elder abuse is very common and that most of us do not realize just how frequently it occurs. Often times, nursing home abuse and neglect happens even when we might be aware of its prevalence. So, how do you best detect elder abuse? If you suspect that an older adult could be the victim of abuse or neglect,  how do you report it?

Getting the Facts About Elder Abuse and Neglect

According to the report from U.S. News, it is often difficult for observers to discern the difference between an “innocent” bruise caused by something like a “bump into furniture” and a more dangerous bruise that could be a sign of nursing home abuse. It is more important now than ever to know the signs and symptoms of elder abuse given the growing senior population throughout the country. Experts predict that nursing home abuse and neglect affects anywhere from 5 to 30 percent of the elderly population, and a study published in JAMA indicated that at least one out of every ten seniors “falls prey to some kind of abuse that’s either physical, psychological, sexual, financial, or neglectful in nature.”

handsIf California nursing home employees go on strike, who will provide care for patients residing in the facilities? Should families of those patients have concerns about nursing home neglect? According to an article in the Marin Independent Journal, sixty nursing home workers went on strike last month in San Rafael following a string of nursing facility violations from government regulators. The strike was aimed at forcing the nursing facility to cease its understaffing practices and to encourage a work environment in which providing a threshold level of care for patients is among the most important logistics of running the facility. Even if such a strike is intended to improve conditions, who cares for patients while employees are on strike?

Understaffing and High Turnover Limits Quality of Care

The recent strike occurred at San Rafael Healthcare and Wellness Center, which is owned by Brius Healthcare Services. With more than 80 facilities in California, Brius is the largest nursing home chain in our state. For the last 18 months, employees of the nursing home have been working without having a contract. Why are employees working without a contract? About a year and a half ago, those workers rejected the terms of a union-negotiated contracted because it did not do enough to deal with the serious understaffing problem at the facility.

file000356994816When older adults continue to live at home with help from a caregiver, elder neglect can become a serious issue. Although some caregivers have medical training and should be expected to care for the elderly in a manner that emphasizes safety, some caregivers are not properly trained and can be implicated in situations of elder abuse and neglect. These situations can become even worse when an older adult needs medical treatment and cannot rely on a caregiver for transport to a hospital or a physician’s office. That is where a new transportation service for the elderly comes in, according to a recent article from the California Health Report.

Mobility is a Significant Issue for the Elderly

Mobility is a significant issue for elderly California residents. Whether an older adult needs transportation to a medical appointment or simply to the grocery store to buy food, a new service can help. Recognizing that elderly Californians often have difficulty getting where they need to—or would like to—go, Eric Wong developed Lift Hero. Lift Hero t is a service that looks a lot like Uber or Lyft, but it is designed specifically for seniors who do not have other modes of transportation.

Could helping more of America’s seniors to live independently be a method for preventing nursing home abuse? If an elderly San Diego resident does not require the kind of care that an assisted-living facility or a residential care facility for the elderly (RCFE) would provide—if she can have that same kind of care at home—would she take away some of the risks of becoming a victim of elder abuse? One of our first steps in preventing elder abuse should be to make care facilities safer for older adults. But at the same time, even if we did want to push for more seniors to live independently, a recent article in Forbes Magazine suggests that our country simply is not providing the kind of assistance that would make this possible.7622108790_a2a735a94a

Older Americans Act (OAA) and Providing Assistance to Seniors

Every year, elder rights advocates and others attend the National Home and Community Based Services Conferences, which brings together professionals in various fields to discuss the state of independent living for older adults and those with disabilities. The conference is sponsored by the National Association of States United for Aging and Disability, and it has more than 1,400 participants. Indeed, Kathy Greenlee, the Assistant Secretary for Aging, gave an opening speech that marked the 50th anniversary of the Older Americans Act (OAA).

What does required care for a nursing home patient with burn injuries look like? Patients who suffer from substantial burn injuries and are residing in nursing homes in Southern California must receive a certain level of care in order to be safe from additional injuries. However, according to a recent article from the Los Angeles Daily News, a Montrose skilled nursing home and two of its staff have been charged in relation to the death of a burn patient. According to the newspaper, the charges indicate that the facility and staff members failed “to provide required care to a resident who was a burn victim.” When does negligence rise to the level or nursing home abuse or neglect?2222910959_90b0c86fa5

Nursing Home Neglect

The nursing home, Verdugo Valley Skilled Nursing and Wellness Center LLC, is alleged to have been “grossly negligent” in its care of a burn victim who previously resided at the facility. The patient had burns on 90 percent of his body, injuries that resulted from an arson fire that occurred about 20 years ago. According to the complaint, which was filed by Attorney General Kamala D. Harris, the nursing home did not provide proper care to the patient, and because of its negligence, the patient died.

Elder advocates and those who work tirelessly to prevent nursing home abuse can be involved in many different professions, including medicine. According to a recent news release from USC News, geriatrician Laura Mosqueda is a “leader in the study and prevention of elder abuse,” and she’s continuing to work toward the prevention and early detection of elder neglect in California. Mosqueda is currently the director of the National Center on Elder Abuse (NCEA), and she hopes that her work in Southern California will have lasting impact on older throughout the region.6240576176_62b88ae159

Interdisciplinary Work to Prevent Elder Abuse and Neglect

One of Mosqueda’s focuses in the prevention and detection of elder abuse and neglect is taking an interdisciplinary approach to the problem. Sometimes we think of elder abuse prevention as a job that falls within the realm of community advocates or healthcare professionals who have daily contact with older adults. And sometimes we note that dedicated San Diego nursing home abuse attorneys play an important role in holding abusers accountable. But Mosqueda has worked to bring together elder advocates in multiple fields and professions on behalf of the elderly community.

According to a recent article from Kaiser Health News and NPR, proposed federal rules are aiming at “modernizing” nursing home safety requirements across the country. What does modernization mean in this context? Given that the proposal contains “hundreds of pages of proposed changes,” which “cover everything from meal times to use of antipsychotic drugs to staffing,” it looks like modernization would require quite a bit of effort. In all likelihood, such modernization is deeply needed to help prevent nursing home neglect at facilities in California and throughout the nation.

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Better Technology Requires Revision to the Rules

If approved the proposed rules will require nursing homes comply in order to qualify for payments from Medicare and Medicaid. Medicare officials also think it’s time for a change. According to Dr. Shari Ling, the deputy chief medical officer for Medicare, “the existing regulations don’t even conceive of electronic communications the way they exist today.”

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