Articles Posted in Nursing Home Citation

According to a report by Masters in Health Care, there are some very disturbing statistics about the long term care facilities that many of our friends, relatives, family members and loved ones call home.

Among the shocking facts revealed are the following:

• Over 30% of nursing homes have had some form of elder abuse either by the staff or other residents, including sexual abuse, physical abuse, psychological abuse, neglect and malnutrition.
• In 2005, nearly 92% of all nursing homes received at least one citation for a deficiency.
• Approximately 90% of the time when there is some form of abuse, it is done by the staff, other residents or non-strangers.
• In 1999 there were 5,000 death certificates for nursing home patients that listed the cause of death to be dehydration, bed sores and food deprivation.
• Most nursing home abuse cases never end up being because of the declining mental capacities of the patients and the failure to detect it by the staff members or the patient’s family.
• Over 50% of all nursing home patients have no close family to watch out for nursing home neglect or abuse.
• Many times a nurse’s aide or other staff member may be called upon to care for as many as 30 patients.
• Approximately 30% of all nursing home patients are overmedicated with tranquilizers.
• Approximately 92% of all nursing homes have at least one staff member who has a criminal background.
• With the aging of America, there are not enough nursing home beds to keep up with the growing need for long term care facilities.
• In 2007, there were nearly 258,000 complaints registered against nursing homes for an average of 20 for each.
• In 2001, one out of four nursing homes received a citation for serious injury or death of a patient.
• The cost of living in a nursing home continues to rise. In 2003, the average annual cost was $66,000 but by 2021 it is expected to be $175,000.
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The California Department of Public Health has fined three Los Angeles County nursing homes a total of $235,000 over the alleged poor quality of care the facilities provided to residents. The Downey Care Center, Fountain View Subacute and Nursing Center, and the Motion Picture and Television Hospital were issued Class “AA” citations, the most serious violations under California law, over patient deaths which occurred at each facility in 2010. According to Dr. Ron Chapman, Director of the California Department of Public Health, the fines were levied after an investigation revealed each patient death resulted from inadequate nursing home care.

The Downey Care Center must pay $80,000 for failing to properly monitor a resident’s blood sugar levels after she returned from the hospital. Because the center purportedly failed to provide appropriate care, the resident fell into a diabetic coma and died.

The Fountain View Subacute and Nursing Center located in the City of Los Angeles received a $75,000 fine for allegedly failing to properly supervise a patient with a record of falling. The nursing home resident died from a brain injury he incurred when he fell out of bed. Additionally, staff at the nursing home could not say how long the man laid helpless on the floor before his injury was discovered.

The Department of Public Health fined the Motion Picture and Television Hospital in Woodland Hills $80,000. The fine stems from an incident during which an Alzheimer’s patient reportedly fell down a flight of stairs while strapped into her wheelchair. The nursing home resident died from her injuries one week after her fall. Unfortunately, the resident also fell down the same flight of stairs in the past.

In California, there are approximately 1,300 licensed resident care facilities. When a licensed nursing home fails to comply with applicable state and federal laws designed to ensure residents are properly cared for, the State of California has the ability to impose monetary penalties. The amount of a fine depends on the severity of the resident care facility’s violation. A nursing home may be fined anywhere between $100 and $100,000 depending on the violation.

Nursing home abuse occurs when the elderly or infirm are injured or die as a result of mistreatment or negligence in a facility tasked with their care. Although most elder abuse cases result from negligence, they may also be the result of physical abuse, sexual abuse, a failure to provide adequate medical care, withholding food, incorrectly or over-medicating, and emotional distress. Unfortunately, nursing home abuse is frequently the result of improperly trained or unqualified staff.

Signs of elder abuse can be tough to detect. A nursing home resident may experience a loss of appetite, unexplained weight loss, dehydration or depression. Residents may also exhibit bruises, broken bones, scratches, bed sores, unexplained accidents, and complain of missing personal items. In order to safeguard the rights of the elderly, it is important to take all complaints of nursing home abuse and neglect seriously. If you suspect a nursing home resident is being neglected or abused, contact a qualified California elder abuse attorney to discuss your concerns.
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Following the death of Johnnie Esco at a Placerville facility, an investigation of similar complaints revealed nearly 150 cases of alleged chart falsification in California nursing homes. In Esco’s case, the Department of Justice reopened its criminal investigation of El Dorado Care Center (Center), the nursing home that allegedly altered Esco’s charts to reflect treatment she never received. After 13 days of neglect, Esco experienced massive bowel obstruction, ultimately leading to her death. Her family sued the Center, alleging fraud, elder abuse, and wrongful death. The family accused the Center of falsifying and altering Esco’s medical charts since her admission. The facility remains under civil and criminal investigation for fraud.

Johnnie Esco, 77, was supposed to be recuperating from a bout of pneumonia at a nearby nursing home when her condition suddenly declined. Like many elderly patients, Esco suffered from chronic constipation, which could result in fecal impaction if left unmanaged. Esco’s physician therefore ordered that nurses perform routine assessments, checking Esco on every shift for possible constipation. The physician also ordered that Esco receive a laxative or stool softener and milk of magnesia daily. Esco’s chart, however, showed no history of constipation or laxative use. The nurses never performed an assessment or asked for Esco’s history.

While Esco did not have a bowel movement for five consecutive days, her chart indicated a “zero” constipation. When the doctor ordered an evaluation of the patient’s abdominal distention, no one performed it. Esco lay critically ill, but her chart showed she had an “extra large” bowel movement and a temperature of 98.8. While she was bedridden and unresponsive, the Center billed Medicare for 170 minutes of physical therapy and 65 minutes of occupational therapy. It seems nobody looked in on Esco before she died. An autopsy revealed a severe bowel obstruction and fecal impaction, contradicting the notes in Esco’s chart.

Esco is not the only patient with a falsified medical chart. A supervisor at a Carmichael facility admitted altering the medical records of a 92-year-old with massive, rotting bedsores. A Santa Monica facility was fined $2,500 for claiming a patient received five days of physical therapy when the nurses responsible for performing the therapy were not at work on those days. Investigations into Medi-Cal Fraud and Elder Abuse reveal that falsification of records in nursing homes is an insidious practice, even when it leads to disastrous human consequences.

Falsifying medical records is a misdemeanor under California law. The California Code of Regulations and Business and Professions Code both require mandatory reporting of the offense. Nevertheless, this is what some providers do “to get the work done.” Nursing assistants admit to charting “in bulk,” documenting medication and treatment that were never given. Some administrators even re-create records to hide neglectful care. Others falsify forms to sedate patients or backdate forged documents to settle disputes. In a practice where providers rely upon the accuracy of medical charts, sloppy or fraudulent record-keeping takes a serious human toll.
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An Oroville, California nursing home, Olive Ridge Post Acute Care, was recently cited fifteen times by the Department of Public Health for failing to follow laws in place to protect residents from improper eviction. According to public documents, Olive Ridge attempted to move out many of its long-term residents to increase beds for short-term rehabilitation residents who are often times required to pay more for their care.

Long-term residents in nursing homes are often considered extremely vulnerable, which is why there are several laws in place intended to protect them from unplanned evictions. According to the citations, Olive Ridge failed to follow several State and Federal laws when it decided to suddenly close down an entire wing of the nursing home and relocate up to fourteen residents that were suffering from severe cognitive issues. To make matters worse, some of the residents were relocated more than 150 miles away from their family with virtually no notice. This understandably created a tremendous amount of anxiety and burden on these residents and their families.

The California Department of Public Health is responsible for overseeing the nursing homes operating within the state to ensure they comply with all state and federal regulations. If you have a complaint that cannot be resolved through direct discussion with the nursing home or an ombudsman, you should contact your local Department of Public Health Licensing and Certification office. A list of the district offices and phone numbers can be found at the CA Department of Public Health website.
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