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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
Alden Terrace Convalescent Hosp. 04/09/08 Class B
Chandler Convalescent 02/13/08 Class A
Chatsworth Park Care Center 03/13/08 Class B
Country Villa Park Marino 01/28/08 Class B(3)
Country Villa Pavilion Nursing 03/19/08 Class B
Ember Health Care 01/31/08 Class AA
Gardena Convalescent Hosp. 02/05/08 Class B
Heritage Manor 03/07/08 Class B
Imperial Convalescent 03/27/08 Class B
Lancaster Health Care Center 02/13/08 Class A
Oceanview Convalescent 02/20/08 Class B
Royal Oaks Care Center 12/11/07 Class B
Sophia Lyn Convalescent 04/14/08 Class B
St. John of God Retirement 02/27/08 Class B
Studio City Rehabilitation 04/02/08 Class A
Sunnyview Care Center 04/29/08 Class B
Tarzana Health and Rehab. 02/13/08 Class A
Whittier Hills Health Care Center 01/07/08 Class B
Windsor Palms Care Center of Artesia 04/15/08 Class B
Orange County
Country Villa Plaza Convalescent 03/12/08 Class B
Fountain Care Center 03/13/08 Class B
Newport Subacute Healthcare 02/06/08 Class A
Palm Terrace Healthcare & Rehab Center 02/01/08 Class AA
Park Regency Care Center 04/11/08 Class B
San Bernardino County Elder Abuse
Cherry Valley Healthcare 02/14/08 Class B
Country Villa Rancho Mirage 02/05/08 Class A(2)
Cypress Gardens Rehabilitation 03/20/08 Class A
The Springs At The Carlotta 03/21/08 Class AA
San Diego County
Children’s Convalescent Hospital 02/21/08 Class B
Edgemoor Geriatric Hospital 05/09/08 Class B
Point Loma Convalescent Hosp. 03/10/08 Class B
Ventura County
Brighton Gardens of Camirillo. 4/16/08. Class B

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 jury in Santa Ana awarded the family of Mary Adams $2 million after the 104-year-old was neglected in a Laguna Hills nursing home. The jury awarded $1 million for the Villa Valencia Health Care’s negligence, and another $1 million in punitive damages.

Juror Rory Paster, a 41-year-old engineering analyst who lives in Huntington Beach, said the jury wanted to “send a message that the company should do a better job of treating patients.”

According to reports, Adams admitted herself into the nursing home after suffering a fractured leg. Shortly after admission, Adams developed pressure sores on her heels, which were ignored, and not adequately treated. As a result, she contracted sepsis, and died about two months after her admission.

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Nursing Home malpractice comes in many forms, and has many names. Some call it nursing home abuse or neglect, others elder abuse, but whatever the name, it’s increasingly becoming a problem in the United States. And it’s not just nursing homes. Residential facilities and home health care providers can commit malpractice as well.

Walton Law Firm LLP has represented victims of nursing home malpractice for more than a decade, and has learned that nursing home malpractice can come in many forms. The most common being simple neglect – the failure to notice a change in the resident’s condition, whether it be the occurrence of bed sores, the development of dehydration or malnutrition, or an obvious injury that is not promptly addressed. The law defines neglect simply as the failure to provide care for a person’s physical and mental needs, and to keep them free from health and safety hazards.

More serious cases are those of intentional conduct such as physical abuse, or the intentional mistreatment of a resident, often in retaliation for some prior act. Or the failure to provide basic care because of issues related to under staffing, such as cases involving multiple falls because staff would not respond to call lights. These cases can fairly be described not as just malpractice, but a conscious decision on the part of the nursing facility to expose residents to the risk of harm.

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Yesterday the Bush Administration announced that it will create a nursing home rating system by the end of the year. The criteria for ratings has not yet been established, but will likely be a combination of state and federal inspection reports, staffing reports, and resident and family satisfaction surveys. The ratings would be placed on a government website.

“The fact a home has a lower rating will likely put them on the path to improvement,” said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services. “I don’t think we’re going to see many people who are very anxious to put a loved one in a one-star home.”

Those looking for information about California nursing homes already have a few options when looking at prospective homes. The California Advocates for Nursing Home Reform have a nursing home guide resource, and the California Healthcare Foundation has its own rating system. Both use the government surveys and staffing reports as a basis for the rankings, so the accuracy of the ratings is based primarily on the government’s information, which can be notoriously unreliable.

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A nursing home in Anaheim has received a $50,000 fine in the choking death of a resident. The resident, a brain injured man in his forties who had swallowing difficulty, choked on a piece of burrito.

According to reports, a caregiver was preparing the man’s meal at Parkview Healthcare Center when he reached for the burrito and put it in his mouth. When he began choking, the Heimlich maneuver was attempted but failed. Caregivers were then instructed to begin CPR, but before doing so, looked in the resident’s file to determine to see of there was a DNR (do not resuscitate) order. There was.

A doubtful nursing then called the man’s sister, telling her “your bother is turning black, do you want him revived?” When the sister responded “yes.” The DNR order was wrong. CPR was started. The man was pronounced dead approximately 30 minutes later. The fine was issued due to the nursing facility’s failure to provide “prompt emergency medical care” as requested by the resident.

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The U.S. Department of Justice is stepping up efforts to reduce nursing home mistreatment of elders through its Nursing Home Iniative. The iniative focuses on improving enforcement of existing laws, training, attention to medical forensic issues, and increasing the use of reliable criminal background checks.

Through its Elder Justice program, the DOJ is also increasing the enforcement of civil and criminal penalties against nursing facilities and others whose mistreatment results in the serious injury or death of elderly residents. It has also created State Working Groups to improve the coordination of federal, state, and local law enforcement in cases of health care fraud.

For more information, visit the DOJ’s website here.

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The son of Maria Cobian, the elderly woman who was hit by a car and killed when she wandered away from her nursing home, has filed a wrongful death lawsuit in Vista Superior Court.

The lawsuit alleges that Palomar Heights Continuing Care Center in Escondido negligently failed to supervise Ms. Cobian, and to ensure the safety of 94-year-old resident, who also suffered from dementia. Ms. Cobian was only a few hundred yards away from the nursing facility when she walked into traffic and was struck by a car. The company of the car that hit Cobian was also named in the lawsuit.

Despite her alleged documented history of trying to leave the facility, and the nursing home’s failure to prevent it, it doesn’t appear that there are allegations of elder neglect under the Elder Abuse and Dependent Adult Civil Protection Act against the facility, which allows for enhanced damages against nursing homes, including pre-death pain and suffering, when certain burdens of proof are met.

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Nursing home abuse and neglect is not always perpetrated by staff members. New research from Cornell University suggests that aggression and violence between residents may be more prevalent than abuse or mistreatment from nursing home employees.

According to the study, peer-on-peer abuse is nursing home is a problem that has received little attention.

“Given that nursing homes are environments where people live close together, and many residents have lowered inhibitions because of dementia, such incidents are not surprising,” said Karl Pillemer of Cornell. “Because of the nature of nursing home life, it is impossible to eliminate these abusive behaviors entirely, but we need better scientific evidence about what works to prevent this problem.”

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New research shows that elderly people suffering from dementia who are given antipsychotic drugs are more likely to end up in a hospital or die, even if the drugs are administered for a very short period of time.

Antipsychotic drugs are frequently used in nursing homes to address the behavioral issues caused by dementia, including aggression, agitation, and delirium. Physicians concede that alternatives to antipsychotics to address this type of behavior are limited.

Many experts feel behavioral interventions should be tried first and antipsychotics used as a last resort, “when the behavior or the psychiatric symptoms are really out of control and causing complete distress not only for the person suffering from Alzheimer’s, but for caregivers all around them,” said Maria Carrillo, director of medical and scientific affairs at the Alzheimer’s Association in Chicago. “It’s important to work these things out with the physician and, of course, do follow-up very closely together, so you can make sure these antipsychotics are having the effect you want and, if not, discontinue them immediately.”

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Washington D.C.’s most powerful lobbyists are being hired by the nursing home industry to fight congressional efforts to reform the industry. The industry is closely watching bipartisan legislation that would significantly increase oversight and enforcement of nursing homes around the country.

The new legislation, recently introduced by Sens. Grassley (R) and Kohl (D), would require nursing homes to fully disclose their ownership structures, and would increase penalties if a patient is injured or dies due to negligent or neglectful care. The industry is expected to pay millions to fight this legislation.

Why would nursing home owners disapprove so strongly of a law that requires them to disclose who actually owns and runs the facilities that provide them such a great profit? Liability. Many owners have created maze-like ownership structures that makes it nearly impossible to find out who actually owns the facility when something goes wrong. It’s not uncommon to have a one corporate entity own the building, who then leases it to a second company (the nursing home), who then contracts with a third company to operate it.

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