Elder Abuse

October 16, 2020

5 Common Nursing Home Neglect Scenarios

One big fear many families have regarding nursing homes is the lack of appropriate and personalized care for their loved ones. Over the years, there have been countless cases of the elderly being abused and neglected in long term care facilities and nursing homes. Families need to be aware that neglect and abuse in a nursing home do not always present with obvious physical injuries, but rather as emotional abuse. In the majority of cases, elderly patient abuse in nursing homes is due to the actions or inactions of the nursing home staff.

What type of neglect can occur in nursing homes?

Medical Health Neglect: This occurs when the nursing staff fails to attend to, prevent, or treat an existing or new health problem in the senior. For example, patients with strokes who are bedridden are prone to bedsores. Universally there are established protocols to help prevent these skin problems, which are sometimes not followed. For instance, diabetic patients not only need their medications/insulin on time, the nursing staff has to simultaneously monitor the blood sugars, which if not controlled can lead to worsening of any open wound, urinary tract infection, or sepsis. Any time a senior has a change in his/her health status like the development of confusion, weakness, inability to walk or speak, this must be reported immediately to the primary care provider to determine the cause. Failure to do so can seriously compromise the health of the senior.

October 2, 2020

Nursing Homes in a Pandemic

By Walton Law, A.P.C.

A nursing home is a private institution that provides a range of accommodations for elderly people and others in need of support. The CDC has found the risk of illness from COVID-19 increases greatly with age. Older adults with underlying health issues that contract the disease may face additional hospitalization, ventilators, intensive care, and even death. Due to the current global pandemic, it is no surprise nursing homes have been hit extremely hard by the respiratory virus.

Nursing Home Care During COVID-19

Many nursing homes have closed their doors to any visitors, so it is difficult to know what is truly going on in these facilities. Although not every coronavirus-death can be prevented, it is important nursing homes take the follow measures to protect their residents:

August 4, 2020

Abuse and Neglect: How Nursing Homes Try to Hide It

By Walton Law, A.P.C.

Placing a beloved family member in a nursing home or long-term care facility is never easy; it requires a lot of trust to leave their care up to the staff and the facility you’ve chosen. You rightfully expect staff and the nursing home to have the highest standards and provide the best, most compassionate care possible – that includes protecting them from neglect or abuse and addressing any lapses in proper care quickly and thoroughly.

Unfortunately, this often does not happen; in 2017, law enforcement were not alerted in over a quarter of serious nursing home abuse cases despite state and federal laws that mandate police notification. In fact, a pattern of behavior to cover up these abuses has surfaced; this means it’s important to be on the lookout for ways nursing homes could be trying to cover their tracks.

Failure to Comply with Reporting Laws

July 21, 2020

How Can I Find Out if a Nursing Home Has a History of Elder Abuse or Neglect?

By Walton Law, A.P.C.

The decision to entrust a loved one’s care to a nursing home or long-term care facility is never easy. Selecting the facility can be just as overwhelming as the initial decision itself. California has approximately 1,230 licensed long-term care nursing facilities that provide care for more than 400,000 patients each year – it’s no wonder selecting a single, high-quality facility can seem like trying to find a needle in a haystack. However, the federal government has provided a tool that can make it easier to avoid facilities that may create an unsafe environment for your loved one.

Nursing Home Compare Site

The federal Centers for Medicare and Medicaid Services (CMS) helps set standards across the nation for long-term care facilities and administer Medicaid and Medicaid payments. They host a website called Nursing Home Compare, which provides data that can help families research facilities and find out information to help them decide on the right place for themselves or their loved one. Currently, nursing homes receive an overall rating, which is determined by combining the results of three categories:

July 14, 2020

Recognizing Emotional Abuse in California Nursing Homes

By Walton Law, A.P.C.

In 2018, 52 million Americans aged 65 and older accounted for 16 percent of the country’s population. The size of this group, set to nearly double in the next 40 years, accounts for the high demand of nursing home and long-term care needs in the United States. As people make the difficult decisions about the care of elderly loved ones, it’s reasonable to expect any facility tasked with caring for a family member to exhibit the highest levels of professionalism, compassion, and respect for them at all times.

Unfortunately, far too often this is not the case. Understaffing, lack of proper training, and insufficient supervision of staff members, nurses, nursing assistants, and health aides all contribute to the abuse of these vulnerable patients. It can be difficult to spot emotional or psychological abuse of a patient – unlike physical abuse that results in bruises or broken bones, they often don’t present obvious signs that something is going wrong.

The difficulty is even greater with the ongoing COVID-19 pandemic, which has resulted in family members being allowed little or no in-person contact with nursing home residents to visit and observe them for signs of abuse. However, it’s still possible to understand common types of emotional abuse and look for signs it may be occurring, even if the victim won’t admit outright that they are being abused.

June 29, 2020

The Problem with Nursing Home Self-Inspections

By Walton Law, A.P.C.

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.

April 21, 2020

Communicating with Loved Ones in Nursing Homes During COVID-19

By Walton Law, A.P.C.

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.

March 16, 2020

Village Square Healthcare Center Cited over Accident Hazards

By Walton Law, A.P.C.

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:

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.”

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.

February 16, 2020

Meadowbrook Health Care Center Cited over Treatment, Food Services

By Walton Law, A.P.C.

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:

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.

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.”

January 16, 2020

What Is Candida Auris?

By Walton Law, A.P.C.

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.”