DO YOU SUSPECT ABUSE OR NEGLECT? Contact Us for a Free Consultation

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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.

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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.”

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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.

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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.

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In 2007, Dr. David Graham, a drug safety expert with the FDA, testified before Congress and stated that approximately 15,000 people die each year in U.S. nursing homes from the off-label use of anti-psychotic drugs. Off-label use is the use of the drug for a condition it was not intended. In California, it has been estimated that up to 60% of all nursing home residents are given psychoactive drugs, which is an increase of 30% in only 10 years. It’s no wonder that when we think about nursing homes, we think of isolated elderly people sitting hunched over in wheelchairs, or in bed, segregated from the world. That life is a sad realty for many.

To combat the misuse of psychoactive drugs, the California Advocates for Nursing Home Reform have released a publication called Toxic Medicine – What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes. The 20-page booklet provides an overview of what psychoactive drugs are, their purposes, the risks associated with them, and an overview of the resident’s rights.

Primary among those rights is the requirement of consent. Before a psychoactive drug can be used, a physician must inform the resident (or his/her decision-maker) about the drug, why it is being recommended, and the risks associated with it, and then must obtain consent before prescribing it. The guide also provides a list of questions that should be asked of a doctor who is recommending a psychoactive drug, and what to do if it is suspected that the drugs are being used without proper authority.

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A few times a year we hear news stories of Alzheimer’s sufferers wandering away from their homes and becoming lost. Those stories end one of two ways, and unfortunately, too often the ending is not a happy one.

These sad stories have created a cottage industry for nursing home providers. We have all now heard of nursing homes advertising themselves with “special neighborhoods for the memory impaired.” Or providing “safe and secure” housing for the Alzheimer’s patient. But what happens when the victim wanders away from those facilities?

A few years ago, such a thing happened in Escondido. Then a 94-year-old woman walked out of Palomar Heights Care Center in Escondido and into the path of a car, killing her instantly. Caregivers told the media that they didn’t know what happened, but a subsequent lawsuit revealed some serious neglect on the part of the home.

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USA Today has analyzed nursing home rankings under Medicare criteria and found that lowest scoring nursing homes tend to stay that way, year after year. Sadly, many of these poor performing nursing homes are the only nursing facilities for miles.

According to this article, twenty percent of the country’s 15,700 nursing homes receive consistently poor ratings for the care they provide. With over 250,000 Americans living in skilled nursing facilities, that represents a huge number of vulnerable nursing home patients who are exposed to abuse or neglect every day.

“We want to see improvements, but we don’t expect a nursing home will jump to a five-star rating within a one-year time period,” said Medicare’s Thomas Hamilton.

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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.

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If you considering using the services of a residential care facility for the elderly or an assisted living facility, you may be wondering how to select a good one. Unfortunately, there is no rating system like you might find in hospitals, and now nursing homes, but there are actions you can take that will help ensure you make the right choice.

The California Advocates for Nursing Home Reform (CANHR) have created a checklist to use when researching care facilities for the elderly. First and foremost, evaluate the most recent inspection report from the California Department of Social Services, Community Care Licensing (DSS). Your local DSS office will have a complete inspection file on every facility within its jurisdiction, and you have a right to review. Simply contact the office and make an appointment to go review the file. (Click here to find your local DSS office).

When reviewing the file, you want to make sure to examine:

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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

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