Articles Posted in Elder Abuse

As the COVID-19 pandemic continues to rage, nursing home residents are among the hardest hit demographic and make up a large portion of the fatalities nationwide. Though the virus is undoubtedly deadly, especially for elderly individuals and those with compromised immunity, the concentration of deaths in nursing homes is concerning. Adding to that concern is the fact nursing homes are currently permitted to self-inspect as a result of the pandemic. The lack of oversight presents numerous issues we’ll explore more.

Independent Inspections Suspended

At the outset of the pandemic, the Centers for Medicare and Medicaid Services (CMMS) decided to temporarily stop regular inspections at over 15,300 nursing home facilities nationwide to focus instead on the coronavirus threat. Instead, routine inspections were developed and implemented as a way to safeguard the residents. Unfortunately, when the government halted its own inspections, it authorized nursing home facilities to self-inspect.

COVID-19, also known as the Coronavirus, has put a stop to the regular structure of our lives. We no longer are able to move about freely and often find ourselves having not spoken to another person for hours at a time. This isolation that has been imposed upon us is what our elderly loved ones feel on a daily basis living in their homes as they age. One way we have all tried to combat this symptom of aging is to place our elderly loved ones into a nursing home. Often times this is out of necessity due to medical concerns, but it also allows for them to have human interaction on a daily basis.

Unfortunately, with COVID-19 spreading throughout our world, we have had to place great restrictions on nursing home visitations. Therefore, while so many of us would go visit our loved ones at their nursing homes on a daily or weekly basis to ensure their treatment and medical concerns were being met, we now are literally locked out of their care. In addition, the nursing homes are experiencing a shortage of workers due to illness and fatigue leaving us to wonder if our loved ones are being properly cared for. Understaffing is a growing problem in the United States and has been for a long time. With the new novel Coronavirus, the rate of understaffing is at an all-time high.

While we understand the need for the lockdown in the facilities to try to ensure the virus does not enter these facilities where many patients have compromised immune systems, the distance is hard for all involved. There are some things that you can still do to see your elderly loved one and ensure their proper care is continuing.

Village Square Healthcare Center, a nursing home located in San Marcos, California, received 29 citations for health and safety deficiencies in its most recent inspection, on February 14, 2019. According to Centers for Medicare and Medicaid Services records accessed on February 26, 2020, that figure numbers more than twice the statewide average of 12.8 citations, and more than three times the U.S. average of 8.0. A for-profit corporation owned by GC Holding Company LLC., Highland Springs Care Center is a Medicare and Medicaid participant with 118 certified beds and an average of 117.8 residents at the facility per day. The deficiencies described in the February 2019 citations include the following:

  1. The nursing home did not ensure residents were adequately protected from accidents. Federal code requires nursing homes to maintain a resident environment free of accident hazards and with adequate supervision to prevent accidents. An inspection found that Village Square Healthcare Center did not provide such in two capacities. According to this citation, an inspector observed water temperatures in resident bathroom sinks that exceeded safe levels. The inspector separately observed that a paraplegic resident was not provided with adaptive equipment to call facility staff. The resident stated in an interview that when he calls the facility’s main number using Alexa and his computer, these calls “go to voicemail 50% of the time,” and that he cannot use his soft touch pad call light provided by the facility “because he cannot turn his head enough to use his chin to turn it on.” The resident stated additionally that while he sends text messages to staff when he requires assistance, “in an emergency his only option would be to call 911.” A Certified Nursing Assistant stated in an interview that she did not know how to retrieve voicemails left by the resident, and that the current system for the resident to contact staff “is not safe.”
  1. The nursing home did not implement adequate measures to prevent and control infection. Federal code requires nursing homes to establish and implement infection prevention and control protocols. An inspection determined that Village Square Healthcare Center failed to do so in three capacities. In one, an inspector observed a staff member assisting residents during mealtime without conducting proper hand hygiene between residents. In another, an inspector observed a staffer moving between residents and providing them assistance without conducting proper hand hygiene. In a third, an inspector observed a resident’s urinary catheter drainage bag lying on the facility’s floor, in contravention of policy.

Meadowbrook Health Care Center, a nursing home located in Hemet, California, received 20 citations for health and safety deficiencies in its most recent inspection, on April 20, 2019. According to Centers for Medicare and Medicaid Services records accessed on February 26, 2020, that figure numbers more than the statewide average of 12.8 citations, and more than U.S. average of 8.0. A for-profit corporation owned by Johnre Care Inc., Meadowbrook Health Care Center is a Medicare and Medicaid participant with 64 certified beds and an average of 48.8 residents at the facility per day. The deficiencies described in the April 2019 citations include the following:

  1. The nursing home did not ensure residents were provided with appropriate treatment. Federal code requires nursing homes to provide residents with “appropriate treatment and care according to orders, resident’s preferences and goals.” An inspection found that Meadowbrook Health Care Center did not provide such in an instance when the facility did not “ensure signs and symptoms of bleeding were monitored” per the plan of care of a resident reviewed for side effects of blood thinner medication. The citation states further that the failure to ensure such “may have contributed” to the resident being sent to the emergency room for rectal bleeding. According to the citation, the resident was receiving an anticoagulant agent to prevent blood clots, and the plan of care stated that they should be monitored for signs and symptoms of excessive anticoagulation. A Licensed Vocational Nurse confirmed to state authorities, however, that “there was no documentation” the resident was being monitored such during the month in question, and “should have been monitored” in the period leading up to the resident being sent to the hospital.
  1. The nursing home did not ensure the competencies of food and nutrition services staff. Federal code requires nursing homes to ensure that its staff have “appropriate competencies and skills sets to carry out the functions of the food and nutrition service.” An inspection found that Meadowbrook Health Care Center failed to ensure its supervisory staff failed to carry out their key functions in an instance wherein the facility’s Dietary Manager and Registered Dietitian “did not provide management and oversight to ensure food was stored, prepared, and served according to facility and industry standards,” as well as that equipment and other food service items were maintained in good working condition. The citation goes on to state specifically that an inspector found that the facility’s RD did not ensure residents were provided with “a comparable in nutrient content alternate” when they requested one instead of the “main entrée.” The inspector also found that the RD did not “report the poor condition” of certain food service items, and that cutting boards and cooking pans were not maintained in good condition. The citation states that these deficiencies resulted in the potential for the facility’s residents to experience “food borne illness and nutritional related health complications.”

In recent years the Centers for Disease Control and Prevention has drawn attention to a source of increasing concern for nursing home residents: Candida auris, also known as C. auris, a fungus that causes “bloodstream infections and even death” in those it affects. Like many infections, C. auris infections are particularly dangerous for those who are already suffering from other conditions. Described by the CDC as “a serious global health threat,” C. auris poses a special risk for nursing home residents.

What makes C. auris so dangerous? A few things. The CDC notes that the fungus is frequently resistant to numerous antibiotic medications; that it is “difficult to identify with standard laboratory methods”; and that it is even prone to misidentification by laboratories without certain technology. This places elderly populations, especially those in nursing homes and other long-term care facilities, at heightened risk. A New York Times report published in September 2019 described a June 2019 study that found “patients and residents in long-term care settings have alarmingly high rates of drug-resistant colonization, which means they carry the germs on their skin or in their bodies, usually without knowing it, and can pass them invisibly to staff members, relatives or other patients.” The study in question “focused on Southern California,” finding that 85% of nursing home residents “harbored a drug-resistant germ.” The CDC has also found that the infection proliferates in long-term healthcare centers

The Times reported that 800 cases of C. auris infection have been identified in the US since the fungus was first reported here in 2015. In August 2019, the CDC updated that count to 806. That includes 388 confirmed cases in New York; 227 confirmed cases in Illinois; 137 confirmed cases in New Jersey; 24 confirmed cases in Florida; and five confirmed cases in California. The Times attributes C. auris’ easy spread through nursing homes to a few factors, in addition to the prevalence of nursing home patients on multiple antibiotics to which the infection has already developed a resistance. Nursing homes are frequently understaffed and under-resourced, according to the Times, and struggle to “enforce rigorous infection control.” They often cycle infected persons in and out of hospitals, putting those hospitals’ patients at risk of the infection too. One health expert told the Times, “You’ll never protect hospital patients until the nursing homes are forced to clean up.” Basic hygienic measures, such as “using disposable gowns and latex gloves,” are essential to combating the infection, yet often unfollowed by long-term care centers, according to the Times. Experts also attribute the infection’s spread in the US to healthcare economics “that push high-risk patients out of hospitals and into skilled nursing homes.” Under the US’s healthcare system, these experts told the Times, “nursing home facilities are reimbursed at a higher rate to care for these patients… providing an economic incentive for poorly staffed or equipped facilities to care for vulnerable patients.”

Elder abuse typically refers to the knowing, intentional, or negligent act by a custodial care provider, caregiver, or any other person that causes harm to a vulnerable adult. In California, anyone aged 65 and older is protected by the Elder Abuse and Dependent Adult Civil Protection Act. The laws are designed to help prevent neglect and abuse to California seniors. Neglect falls within the definition of elder abuse, and unfortunately may have dire consequences to the victim.

In broadest terms, neglect is a type of elder abuse wherein a caregiver fails to provide the elder with basic needs including water, food, shelter, heat/air-conditioning, personal hygiene products and medical assistance. Failure to adequately move or reposition a bedridden elder, for example constitutes neglect, just as failing to keep elders properly nourished and hydrated constitutes neglect.

Neglect is particularly dangerous for elders, as it can lead to life-threatening consequences. Such consequences of neglect include:

The Elder Abuse and Dependent Adult Civil Protection Act (Act) was strengthened in 1991, when California legislature added Welfare & Institutions Code §15657 to the Act. This was done to specifically address the needs of California elders and the unique struggles they face, to include elder abuse, neglect, and abandonment.

Because elders may be seen as a disadvantaged class, California elder abuse attorneys who advocate for elders who have been abused, or the families of those who have passed away, are able to charge attorney’s fees and costs to the defendant (abuser). This helps those whose loved elders were mistreated by others who intentionally acted in a reckless, malicious, fraudulent, or oppressive manner to recover damages for the elder, or the family if the elder is deceased.

As such, those who can sue for Elder Abuse in Southern California will include both the family members of the abused elder (if the elder is deceased), or the elders themselves. If the suspected victim has died as the result of abuse or neglect while residing in a California nursing home, the family has the right to file a lawsuit on behalf of their deceased elder, and the court proceedings will ensue as if the elder were still living.

In many cases, where the elder has died, and the family believes the death was caused by misconduct, negligence, or abuse by the hands of another, two cases will evolve. One case will directly address the abuse, and proceed as if the elder were still alive. The second will be a wrongful death case filed on behalf of the survivors. The cases are very different. The injury/abuse case will take into account the injuries sustained by the elder, which will then be granted to the deceased elder’s estate. The wrongful death suit will serve to compensate the family and heirs of the elder who has passed away.

If you are unsure as to whether or not you have a case for an elder abuse lawsuit, contact Chris Walton today for a free consultation. Chris is an award winning elder abuse attorney who is based in San Diego, CA. Walton Law, APC focuses their entire practice on advocacy for elders who have been abused, or those who have suffered grave personal injury. Click here to schedule a consultation.
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The antibiotic is considered one of the greatest achievements in the history of mankind.  However, scientist have been studying antibiotic resistance since the 1940’s.  In 1947, penicillin became ineffective against its first bacterium.  Unfortunately, only as recent as 2017 have nursing homes been forced to develop, implement, and maintain an antibiotic stewardship program.

An Overview of the Problem

In any long-term care facility, the spread of bacteria and viruses is all but inevitable.  Mitigation techniques such as hand washing, frequent bathing, linen changes, and contact precautions do help, but at some point, this is not enough.  Increasingly, nursing home residents are being prescribed antibiotics even when their indications do not meet the criteria.  You may be surprised to know that, according to the CDC, 50%-70% of nursing home residents are prescribed antibiotics in any rolling 12-month period.  Additionally,

If you have a loved one in a long-term care nursing home, you know how difficult it can be to visit more than once or twice per week.  You are the eyes and ears of your elderly family member, but who is looking out for them when you are not around?  The Long-Term Ombudsmen of Riverside County do just that.

What Is a Long-Term Care Ombudsman?

In 1978, amendments to the Older Americans Act mandated that each state create an Ombudsman Program.  The Older Californians Act further solidified the funding and presence of the program by supporting the development of the Office of the State Long-Term Care Ombudsman (OSLTCO).

Financial abuse of elders is an unfortunate reality. In fact, elders are often specifically targeted by criminals looking to commit fraud and identity theft. There are many ways to prevent fraud and identity theft. It is important for elders, or their loved ones, to monitor their credit, and regularly review account statements to try to prevent or stop financial abuse.

All Californians are entitled to one free credit report per year from each of the three major credit reporting bureaus, Experian, Equifax, and TransUnion. To get your free annual credit report visit www.annualcreditreport.com. This federal government approved website will enable you to pull your credit, or the credit of a loved senior, and receive a full report once each year.

While one free credit search is made available each year, elders would be smart to check their credit 2 or 3 times per year. Credit reports typically cost less than $20, and provide invaluable peace of mind by confirming that unauthorized accounts have not been opened, nor have illegitimate items been charged.

In addition to obtaining regular credit reports, it’s a good idea to have duplicate copies of monthly account statements sent not only to the elder, but to their trusted Financial Advisor, attorney, CPA, or a trusted family member. This will provide additional confirmation that all charges appear accurate, nobody has acquired the account number, and it is not being used without the consent of the elder.

Warning signs of fraud on bank statements may include:

*Withdrawals from outside of the elder’s primary area residence;
*Repeated withdrawals, particularly if the elder spends most of their time at home; and
*Checks written to unusual or unfamiliar people, organizations, or stores.

Keeping an eye on credit is important for Californians of all ages. However, it is especially important to monitor credit statements and account balances for elders who may have declining mental capacities, or medical conditions such as dementia that put them at greater risk for becoming a victim of financial elder abuse.

If you suspect, or confirm that your loved elder is the victim of financial abuse in California there are certain steps you should take. You may report any suspicion of abuse to the National Elder Abuse Hotline at 1-800-677-1116. In California, reports can be made to the local county Adult Protective Services Agency or to local law enforcement.
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