Articles Posted in Nursing Home Citation

The Department of Justice and the Department of Health and Human Services have released “The Elder Justice Roadmap” on their website: www.hhs.org:

Supported by the Department of Justice (DOJ) and the Department of Health and Human Services (HHS), the Elder Justice Roadmap was developed by harnessing the expertise of hundreds of public and private stakeholders from across the country and by gathering their input. The goal of these expert summits was to identify the most critical priorities and concrete opportunities for greater public and private investment and engagement in elder abuse issues. The Elder Justice Roadmap reflects the knowledge and perspectives of these experts in the field and will be considered by the Elder Justice Coordinating Council and others in developing their own strategic plans to prevent and combat elder abuse.

“The Roadmap Project is an important milestone for elder justice,” said Associate Attorney General Tony West. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” he explained. West continued, “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.”

Understaffing nursing homes is incredibly dangerous to adults over 65 residing in long-term care facilities such as Southern California nursing homes. That’s precisely why specific laws and regulations are in place which mandate proper staffing at long-term care facilities.

Under California law, “The facility shall employ an adequate number of qualified personnel to carry out all of the functions of the facility” Health & Safety Code § 1599.1(a). Moreover, Health & Safety Code §1276.5-1276.65 mandates that nursing homes must provide a minimum of 3.2 nursing hours per patient per day.

Unfortunately, many facilities choose to ignore the California law. Even worse, the understaffing of nursing homes has been directly correlated to abuse and neglect of elders. Indeed, understaffing in California nursing homes leads to substandard care over and over again. Substandard care in nursing homes then leads to illness, injury, and too often, death.

Understaffing nursing homes is incredibly dangerous to adults over 65 residing in long-term care facilities such as Southern California nursing homes. That’s precisely why specific laws and regulations are in place which mandate proper staffing at long-term care facilities.

Under California law, “The facility shall employ an adequate number of qualified personnel to carry out all of the functions of the facility” Health & Safety Code § 1599.1(a). Moreover, Health & Safety Code §1276.5-1276.65 mandates that nursing homes must provide a minimum of 3.2 nursing hours per patient per day.

Unfortunately, many facilities choose to ignore the California law. Even worse, the understaffing of nursing homes has been directly correlated to abuse and neglect of elders. Indeed, understaffing in California nursing homes leads to substandard care over and over again. Substandard care in nursing homes then leads to illness, injury, and too often, death.

As a nursing home abuse and neglect lawyer, one of the most common questions is, “how do I choose the right nursing home for my loved one?” Unfortunately, there is rarely an easy answer to this question. However, there are some important guidelines listed below that I believe will assist you in selecting the most appropriate nursing home for you or your loved one.

Make a List:

Similar to any other big decision in life, there is no substitute for doing your homework and acquiring as much information as you can. Start by making a list of the nursing homes in a community close to relatives, friends, and/or people that will visit your loved one while in the nursing home. To obtain a list of nursing homes, you can contact your local California Department of Public Health District Office. Alternatively, California Advocates for Nursing Home Reform maintains an online nursing home guide that is very helpful.

ISE_webbanner_768x180It is an unfortunate fact that elder abuse is a common and growing problem in San Diego and throughout the United States. Abuse of the elderly can take many forms, ranging from neglect and abandonment to physical, verbal, financial, and even sexual abuse. Fortunately, professionals in health care are constantly working towards new breakthroughs in treatment and the prevention of abuse in the elderly population. It’s true that new research and techniques are changing the face of convalescent care every day.

As the population of elders in San Diego continues to grow, it’s also encouraging to see the elder abuse epidemic be drawn out of the shadows and into the light, so we can all learn to recognize symptoms of elder abuse, and report any suspicions. One such example of shining a light on elder abuse prevention will be coming to Southern California next month.

On September 15, 2016 the 2-day USC Judith D. Tamkin International Symposium on Elder Abuse will welcome “researchers, academics, physicians, nurses, and psychologists” to participate in a weekend committed to “Closing the Research Gaps and Moving the Field of Elder Abuse Forward.”

Perhaps in response to the revelation that the California Department of Public Health has been negligent in investigating claims of elder abuse occurring in nursing homes and assisted living facilities across the state, Governor Jerry Brown’s proposed fiscal budget includes the addition of roughly 260 positions in the Licensing & Certification Division of the California Department of Public Health.

A statement issued by the California Advocates for Nursing Home Reform (CANHR) in response to the proposed budget reads:

“According to the Department’s Budget
Change Proposals, the Department is requesting the new positions primarily because its prior methodology for assessing its staffing needs failed to consider that inspectors were needed to investigate its vast backlog of complaints or to finish complaint investigations and write reports after onsite visits were conducted.”

Unfortunately, even given the influx of a proposed $30 Million, and the addition of hundreds of jobs, CANHR also said that it is expected to take an additional four years for all pending investigations to be completed. Their statement further said:

“In other words, the Department allowed thousands of complaints involving nursing home abuse and neglect to languish for years because its leaders could not competently perform the most basic assessment of its staffing needs. Some of these failed leaders remain at the Department and should be replaced by qualified and competent managers before it is awarded any more money.

CANHR calls on Governor Brown to swiftly appoint a new leadership team at the Department of Public Health. The new leaders should have the qualifications, experience, and will to build the Licensing & Certification Division into a premier consumer protection agency that will protect the interests of nursing home residents and patients of other health facilities throughout California.”

If you suspect that an elder is being abused, it is vital to report your concerns immediately. Under California law elder abuse can be both a criminal and civil offense. The state of California has taken a firm stance and zero tolerance policy towards elder abuse in any capacity. As part of their mission to encourage all Californians to report suspected elder abuse, the state has created The Citizen’s Guide To Preventing and Reporting Elder Abuse, which can be viewed in its entirety here. You should report suspicions of elder abuse to:

• Local Law Enforcement, including the Police, Sheriff, and District Attorney’s office. The San Diego County Sheriff’s Department can be reached at (858) 565-5200. The San Diego County District Attorney may be reached at 619-531-4040.
• Long-Term Care Ombudsman Program provides a 24/7 Crisis Complaint Hotline at 800-231-4024.
• Adult Protective Services (APS). In San Diego County, you may contact: San Diego County Aging and Independent Services (858) 495-5660.
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Southern California elders – particularly those residing in nursing homes, or skilled nursing facilities – are unfortunately prone to developing life-threatening bedsores. Bedsores, which are also known as pressure ulcers, can lead to a host of health problems, particularly in elders whose health may already be compromised. Similarly, because many elders may be confined to a bed or wheelchair, their risk for developing these sores is increased.

According to the Mayo Clinic:elderlyWomanInBed.jpg
People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Immobility may be due to:

•Generally poor health or weakness
•Paralysis
•Injury or illness that requires bed rest or wheelchair use
•Recovery after surgery
•Sedation
•Coma

However, more specific risk factors affecting elders which make them so susceptible to bedsores may include advanced age, which results in thinner, drier, less elastic skin, which is generally more fragile. Elders may also develop bedsores after significant weight loss, which can accompany a long-term illness. Poor nutrition and/or dehydration also make elders susceptible to developing dangerous bedsores. Illnesses such as diabetes, and vascular diseases may also lead to damaged skin tissue, making it easier for a bedsore to develop. Likewise, elders who suffer from bowel or bladder incontinence are also likely to develop bedsores if soiled clothing isn’t removed and replaced immediately.

Similarly, elders who are in a state of mental decline are typically more likely to develop dangerous bedsores. Those who have limited mental alertness may be unaware that sores are developing, leading them to progress into dangerous infections before being discovered. By the same token, any elder who has diminished sensory perception, such as those who are paralyzed, may also not discover bedsores until they have reached a dangerous stage.

The key to prevention (and treatment) of bedsores is to relieve pressure. This can be accomplished most effectively by repositioning an elder regularly, particularly once a bedsore has developed.

For elders residing in a Southern California nursing home, inspection of the skin should be a routine part of care. Unfortunately, all too often patients suffer from bedsores due to neglect or lack of an appropriate care plan implemented in the California nursing home. If you have found a bedsore on an elder you know, a doctor needs to be notified immediately. Bedsores can often be resolved with appropriate detection and treatment.

While many long-term care facilities in California provide excellent care, others subject their patients to many forms of neglect or elder abuse. The California Welfare & Institutions Code §15610.57, addresses “neglect” in part by stating it is “the negligent failure to exercise the degree of care a reasonable person would have exercised had they had the care and custody of an elderly person.” This would include the failure to protect that elder from dehydration, bedsores, falls, other injuries caused by safety or health hazards and any type of injury that does not fit the explanation provided by the staff.
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signing a bill.jpg Governor Jerry Brown made it clear that assisted living facilities in California will be held accountable for violations of state regulations, to the tune of a 100% increase in fines.
Until recently, fines for violations at assisted living facilities maxed out at a measly $150.00. The top fine will now be $15,000.00. This is just the latest step in a statewide effort to increase oversight of assisted living facilities. The Governor also signed 9 additional assisted living reform bills, which marks the single greatest overhaul of the elder care facility industry in almost 30 years.

This bill was co-authored by San Diego’s own Assemblyman Brian Maienschein, and extends to cover all community care facilities, not just nursing homes. So far, Governor Brown has signed 13 new bills designed to protect our elderly into law this year. The San Diego Union Tribune has a great article which explains the details of the new law. It can be read in its entirety here.

At Walton Law, APC, we are very pleased to see our politicians working harder to protect our seniors. We certainly hope that the increase in fines will prompt elder care facilities throughout the state to begin to honor the rights of patients and elders living within assisted living facilities and nursing homes throughout the state as they have promised the families of these loved one they would.
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In one of the most recent and most alarming incidents of neglect and elder abuse, a Castro Valley assisted living facility was shut down a few weeks ago by Social Services after multiple complaints. But what happened after the closure may lead to not only civil, but criminal charges against the owners.

After the facility was officially closed down, it appears that the assisted living facility staff left as well, leaving more than one dozen elderly patients with just a cook, a janitor and a caretaker for an entire weekend. A medical call alerted authorities to the fact the residents had more or less been abandoned. Some of them were bedridden, and wheelchair bound. From here, the district attorney will decide what type of criminal charges the owners of the facility will face. All patients have since been moved to other hospitals and facilities.

It is horrifying to see such blatant abuse, and neglect of the elderly, but unfortunately it is not uncommon. Elder abuse, including neglect occurs in long term care facilities in California with alarming frequency.

Los Angeles ABC 7 News recently partnered with the Center for Investigating Reporting to shine a light on alleged abuse cases, which are being poorly investigated by the California Department of Public Health. The partnership has revealed that the agency is leaving allegations of elder abuse unexamined for years.

According to ABC-7’s website: “Investigators at California’s Department of Public Health are responsible for keeping dangerous people out of the health care business. But an investigation by our partners at the Center for Investigative Reporting says the agency is failing to protect some of the state’s most vulnerable: the elderly.

They’ve uncovered alleged abuse cases that the agency left unexamined for years — even some that ended with fatal results.