• Suspect nursing home abuse or neglect?
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Is elder care in America working, or do we need a new system to ensure better nursing home quality of care for seniors?  According to a recent article in Forbes, the system as it currently stands just is not working.  Indeed, the author suggests that the disproportionate attention to caution and safety results in risk aversion, which actually may diminish the quality of care that the elderly receive at nursing homes and assisted living facilities.

Nursing Home CareDoes Risk Aversion Result in Lower Quality of Life?

Why would risk aversion result in seniors experiencing a lower quality of life?  The article explains that many assisted-living facilities are particularly concerned about accusations of neglect.  As a result, each time a patient complains of pain or falls, staff at the facility will call an ambulance.

For example, a woman with dementia was residing in an assisted-living facility.  The elderly woman had an anxiety issue about needing to use the bathroom, and often complained and became agitated when she did not have easy access to a toilet.  She often fell without sustaining obvious injuries, but each time, the staff would call EMTs to take the woman to the hospital in an ambulance.  When she arrived at the emergency room, she was not classified as a high priority patient.  As such, she would lay on a gurney and wait to be seen.  While waiting, she would experience extreme anxiety about being unable to use the bathroom.  Following these unnecessary hospital visits, it would take “several days” for her to “recover her cognitive function back to its baseline” given her dementia.

Years later, the same woman eventually required care in a nursing home.  When the facility recognized that she occasionally had trouble eating without choking on her food, she was placed on “a soft diet with thickened liquids.”  What is wrong with this?  It “meant that one of her few remaining pleasures was removed.”

Maintaining the Right to Take Informed Risks

Should assisted-living facilities and nursing homes accept waiver liabilities for older patients who want to maintain a better quality of life while risking injury?  According to the Forbes article, elder care facilities are extremely hesitant to accept waivers such as these.  But should older adults maintain the right to take informed risks at the possible detriment to a facility’s reputation?

According to the California Department of Public Health, nursing home residents in California do maintain specific rights.  While many of the “Nursing Home Residents’ Rights” concern receiving certain treatments rather than refusing them, the language is clear for elder residents’ rights: “you have the right to accept or refuse treatment, and if you accept, you have the right to change your mind for any reason at any time.”  While consent typically is implied for routine care like bathing and feeding (or is given in the admission agreement to the facility), residents should still know that they do have rights with regard to their treatment, and even their routine care, when they’re in a nursing home or assisted-living facility.

Do you have questions about your elderly loved one’s rights in a nursing home or concerns about nursing home abuse?  Contact an experienced San Diego nursing home abuse lawyer at the Walton Law Firm today.

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Elderly Conservatee Rights Violation

Behind the Medicare Star Rating System

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Elder abuse is much too common across the country, and nursing homes and assisted-living facilities in California have proven particularly prominent offenders of nursing home abuse and neglect.  What do we need to prevent elder abuse in our state?  Many elder rights supporters believe that policy changes might help, and a recent grant aims to help with this kind of advocacy work.

Southern California file0001159645301Center Receives Advocacy Grant

According to a recent news release from the University of Southern California, the Keck School of Medicine became the sole grant recipient to fund the National Center on Elder Abuse (NCEA).  The NCEA is, according to the article, “a vital clearinghouse created by the Administration on Aging,” which is part of the U.S. Department of Health and Human Services.

The $2.2 million grant will be dispersed over a three-year period to fund NCEA programs.  The programs will include some of the following:

  • Technical assistance and training programs for states and community-based organizations to develop their own methods for generating elder abuse awareness and prevention;
  • Intervention and response efforts to address elder abuse claims among authorities and administrators;
  • Increasing identification and reporting of elder abuse;
  • Improving the ability for those within the elderly community to detect, intervene in, and prevent the abuse of others; and
  • Researching possible policy changes on behalf of the elderly in California and across the country.

Top Los Angeles Hospital to Direct Elder Abuse Initiatives

It is extremely important to raise awareness about elder abuse and to develop measures to prevent it.  Laura Mosqueda, who serves as the chair of the department of Family Medicine and Geriatrics at the Keck School of Medicine and as the director for the NCEA, emphasized the striking number of older adults who sustain injuries from abuse.  Indeed, “one in 10 Americans over age 60 suffer some form of elder abuse,” she explained, and noted that the number totals to about “5 million seniors each year.”

As Mosqueda elaborated, advocates at the Keck School of Medicine and the NCEA view “elder abuse, neglect, and exploitation as one of the most pressing civil rights issues facing our aging society.”  Now, since the Keck School was named as the National Center on Elder Abuse, Mosqueda believes that Southern California can become a focal point for elder abuse advocacy work.

Mosqueda believes that Keck will serve as “the entity others look to when they need state-of-the-art information,” and that it will also act as a leader in fields of advocacy, education, and research aimed at preventing nursing home abuse and neglect.  Keck Medicine is routinely recognized as one of the best hospitals in the country, according to data compiled by U.S. News and World Report.

Contact an Elder Abuse Attorney

Do you have an elderly parent who currently resides in a nursing home or assisted living facility?  While most of us do not like to think about the risks of elder abuse in these facilities, it is important to make sure that your loved one is safe and receives proper care.  If you suspect elder abuse or neglect, contact an experienced San Diego nursing home abuse attorney to learn more about your options.

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Class Action Against California Nursing Home Owner

Fines to Increase at Assisted-Living Facilities

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Changes are on the way for nursing homes and California assisted living facilities.  In the midst of shifts to the law, victims of nursing home abuse are filing a class action lawsuit against the owner of 57 skilled nursing facilities in the state, according to an article from Courthouse News Service.  The owner, Schlomo Rechnitz, owns more facilities in the state than any other, with nurfile451297827287 (1)sing homes in nine different California cities, according to a recent report in the Long Beach Press-Telegram.  Rechnitz’s facilities are accused of “chronic understaffing” with allegations of “Actual or suspected abuse or neglect.”

Details of the Class Action Lawsuit

The lawsuit was filed after several years of investigation into the practices at many of Rechnitz’s facilities.  Rechnitz owns Brius Management and Brius LLC, and he owns nursing homes in Inglewood, Los Angeles, Norwalk, Pasadena, San Gabriel, and several other California cities.

According to the lawsuit, investigators discovered that “Rechnitz and his corporate entities hid their history of violating nursing industry laws and regulations from patients and prospective patients.”  In addition, the claim alleges that Rechnitz “chronically understaffed and underfunded the facilities to enhance his profits.”

Brius issued a statement denying the allegations in the lawsuit.  Specifically, the company said that it meets and even exceeds California’s staffing requirements.  According to the articles reporting on the case, in terms of monetary damages, the class action calls for an unspecified amount.  However, it also requests specific action to be taken by Brius and Rechnitz’s other entities, including some of the following:

  •      Compliance with laws governing health care facilities;
  •      Abiding by reporting requirements for future violations;
  •      Drafting a clear policy with procedural requirements when there is suspected patient abuse or neglect.

Based on a statement from Patricia McGinnis, the executive director of the California Advocates for Nursing Home Reform (CANHR), it is not surprising that Rechnitz’s facilities would have problems when it comes to nursing home abuse and neglect.  According to McGinnis, “most facilities in California have issues.”  Indeed, she explained, for-profit skilled nursing facilities are particularly to blame, as “their allegiance is to the investors, not to the nursing home residents.”

Related Nursing Home Abuse Claims

The class action is not the first mention of Rechnitz’s name in terms of nursing home abuse allegations.  According to Michael Connors, an elder rights advocate with CANHR, Rechnitz and his Brius company were the subjects of “an emergency motion filed in August by the California Attorney General’s Office.”

That motion referred to Rechnitz as “a serial violator of rules within the skilled nursing industry.”  It pointed to specific instances in which Rechnitz’s companies would not turn over materials to the California Department of Health Care Services.  Connors explained that CANHR is “troubled by the poor performance factors and by the high number of deficiencies” in Rechnitz’s facilities, and the advocacy group worries that older adults in these nursing homes are not receiving the proper quality of care.

If you have an elderly loved one at a nursing home in Southern California, it is important to ensure that your loved one stays safe and receives the care that she or he needs.  If you suspect that an older adult has been the victim of nursing home abuse or neglect, you should contact an experienced San Diego nursing home abuse attorney.

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Fines to Increase at Assisted-Living Facilities

Nursing Homes and Federal Reporting Requirements for Elder Abuse

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New Bill Raises Penalties for ElderSacramento_Capitol Abuse and Neglect

Is the state of California taking seriously the problems with nursing home abuse and elder neglect at assisted-living facilities?  According to a recent article in UT San Diego, Governor Jerry Brown just signed into law a bill that will impose “a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.”  Before Governor Brown signed the bill, the highest fine for a violation that results in the death of a resident was only $150.  Now, the top fine rose drastically to $15,000.

Fines for elder abuse and neglect resulting in the death of an older adult are not the only penalty increases.  To be sure, the bill will also raise the maximum fine for “violations leading to serious injury or abuse from $150 to $10,000.”  And the new law will not just apply to assisted-living facilities, as was originally proposed in the bill co-authored by Assemblyman Brian Maienschein of San Diego.  It will “apply to all community care facilities in the state.”

Governor Brown already signed 13 different bills related to reforming assisted-living homes in California.  The legislature is working to effect change in our state, and new laws will apply to more than 7,500 facilities across California.  According to the article, these bills represent the “most sweeping overhaul of the industry in nearly three decades.”

Legislation Aimed at Residents’ Rights

In addition to increasing penalties for violations, the new legislation also provides residents in assisted-living homes with a statutory bill of rights.  It looks a lot like the bill of rights that currently exists to protect patients in nursing homes.

What else will the bills bring?  Staff at assisted-living facilities must now meet “stiffer training requirements.” For instance, administrators will face a training mandate of 80 hours, which is double the 40-hour training time required before the new laws. Staff trainings will also provide greater information about caring for residents who suffer from dementia.

Additionally, the owners of these facilities “will pay higher licensing fees.”  In fact, licensing fees will see a “20-percent hike,” which is “enough to provide much needed funds to the Department of Social Services” as it regulates assisted-living facilities throughout the state. The new laws will also require that a staff member trained in CPR “be present at the homes at all times,” and employees will be freer to call 911 for assistance with residents who need medical treatment.

According to Patricia McGinnis, the executive director of California Advocates for Nursing Home Reform, the new reform package signed by Governor Brown is “a major victory for assisted living residents.”  Yet, she emphasized that there’s still more work to be done.  “We look at it as a good start,” she explained, “but we’re not finished by any stretch of the imagination.”

Do you have an elderly loved one who currently resides in an assisted-living facility?  It is very important to know the signs and symptoms of elder abuse and neglect.  If you suspect that an older adult has been the victim of abuse, contact an experienced San Diego nursing home abuse lawyer today.

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Nursing Homes and Federal Reporting Requirements for Elder Abuse

Elderly Conservatee Rights Violation

Photo Credit: Sascha Brück via Wikimedia Commons

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Are nursing homes in California abiding by federal regulations for reporting allegations of elder abuse or neglect?  According to a recent report released by the Office of the Inspector General for the Department of Health and Human Services (HHS), not all facilities are reporting incidents of nursing home abuse.

Reporting Requirements and IncrHHSeasing Rates of Elder Abuse

The HHS report emphasized that about five million elderly Americans (or ten percent of the elderly population) sustain injuries from physical abuse, neglect, and financial exploitation.  However, these crimes are not always reported.

Under federal regulations, nursing home residents “must not be subjected to abuse by anyone, including, but not limited to, facility staff.”  In addition, those nursing home residents have “the right to be free from mistreatment, neglect, and misappropriation of property.”

When it comes to reporting, all nursing facilities that are Medicare and/or Medicaid-certified “must report alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source and misappropriation of property.”  Any allegations of abuse or neglect must be reported to “the facility administrator or designee and the State survey agency within 24 hours.”  Additionally, the results of investigations that take place following a report of abuse must be reported within five working days to the same state authorities.

Federal law also requires “owners, operators, employees, managers, agents, or contractors of nursing facilities” to report any “reasonable suspicions of crimes.”  In other words, if you are affiliated with a nursing home, you are very likely required to report signs or allegations of elder abuse.

Methods and Conclusions of the HHS Study

HHS undertook the study to protect the health and safety of nursing home residents, especially given that the elderly population is on the rise.  HHS researchers reviewed policies on abuse reporting and policies related to reporting suspicious incidents at a sample of nursing homes across the country; it also conducted surveys of administrators at those facilities.  The study took a close look at the allegations that were reported.

The researchers came to some of the following conclusions:

  • 85 percent of nursing homes sampled reported at least one allegation of nursing home abuse or neglect in 2012;
  • 76 percent of those nursing homes had clear policies that addressed federal regulations for reporting;
  • 61 percent of nursing homes kept documentation about their compliance with federal reporting regulations;
  • 53 percent of allegations likely were reported properly.

In short, a number of nursing homes are reporting some incidents of elder abuse, but it is quite likely that only about half of all nursing facilities are properly reporting all incidents of abuse or neglect that take place.

If your elderly parent or loved one may have been the victim of nursing home abuse, it is important to contact an experienced San Diego nursing home abuse lawyer.  Even the smallest signs and symptoms can cause reason to worry, and you should always speak with an elder justice advocate about your case.

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Elderly Conservatee Rights Violation

California Nursing Home Sued for Overmedicating Residents

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A recent article in the Examiner alleges that Scott Phipps of Phisco Fiduciary committed elder abuse against a senior conservatee, Elinor Frerichs.  Elder advocates argue that Scott Phipps kept Frerichs “confined and isolated” at Lakeside Park, her asfile0001748266226sisted living facility in Oakland.  If true, the fiduciary may have violated the rights provided to conservatees in the state of California.

Conservatee’s Rights in California

According to the Notice of Conservatee’s Rights, our state makes clear that, when an elderly person becomes a conservatee, they do not lose all rights to handle decisions.  Indeed, “he or she does not necessarily lose the right to take part in important decisions affecting his or her property and way of life.”  The conservatee is entitled to “ask questions and to express concerns and complaints about the conservatorship and the actions of his or her conservator.”

The conservatee retains the following rights after a conservator is appointed:

  •      Right to be represented by a lawyer;
  •      Right to ask a judge to replace the conservator;
  •      Right to ask a judge to end the conservatorship;
  •      Right to make a will or change a will;
  •      Right to directly receive and control his or her salary; and
  •      Right to control an allowance (defined as “personal spending money” authorized by the court).

Elder Advocates Allege Fiduciary Committed Elder Abuse

According to the article, Elinor Frerichs was denied the right to see visitors, or even to maintain any contact with the outside world.  Scott Phipps, a Professional Fiduciary through the Professional Fiduciaries Bureau (PFB), denied Frerichs access to visitation, phone calls, or personal mail—all of which are guaranteed by Assembly Bill 937 (2013).  Assembly Bill 937 amended the California Probate Code to “clarify that conservatees have the right to visitation, phone calls, and personal mail.”  The Notice of Conservatee’s Rights already emphasizes that conservatees have the right to see visitors.

On September 12, Phipps asked a judge to “[t]ake away Elinor’s right to visitation.”  Frerichs previously stated she wanted to attend her hearing to ask the judge to replace her conservator because she no longer wanted Phipps as her conservator.  However, Phipps did not permit Frerichs to attend her hearing (as she is permitted to do by the Notice of Conservatee’s Rights), and thus “failed to represent Elinor’s wishes to the judge.”  Based on Phipp’s presentation to the court, “the judge limited Elinor’s visitation rights going forward.”

On September 15, Elaine Renoire, President of the National Association to Stop Guardian Abuse (NASGA), phoned Lakeside Park and requested to speak with Frerichs, but Lakeside Park would not allow Frerichs to receive the phone call.  Other elder advocates expressed serious concern about Scott Phipps and the role of conservators, as well as the possible role that Lakeside Park played in permitting elder abuse.

If your elderly loved one has been mistreated in a nursing home or assisted living facility, do not wait to contact an experienced San Diego nursing home abuse lawyer.  At the Walton Law Firm, our elder abuse lawyers can discuss your case with you today.  Contact us to learn more.

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Northern California Nursing Home Sued for Overmedicating Residents

Sacramento Lawyer Charged with Elder Abuse

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Nursing homes in California should take note of the negative publicity surrounding elder abuse and assisted-living facilities in our state.  A recent article in the Santa Cruz Sentinel described serious nursing home abuse allegations that point to fraudulent Medicare claims and poor patient treatment.  In Watsonville, located in Santa Cruz County, the owners of two nursing homes are facing a lawsuit.  According to the report, federal prosecutors sued the owners “allegiDSC08554-bng that leaders made fraudulent Medicare claims” and “persistently and severely overmedicated elderly and vulnerable residents.”

Overmedication and Fraud Allegations

The two nursing homes at issue are Country Villa Watsonville Easy Nursing Center and Country Villa Watsonville West Nursing Center, both in Santa Cruz County.  The owners have been linked to serious crimes connected to nursing home abuse and neglect.

According to U.S. Attorney Melinda Haag, these facilities “accepted more than $20 million in Medicare and Medicaid payments from 2007 to 2012.”  While Medicare and Medicaid can provide legitimate payments for patient care, Haag emphasized that much of these funds “went to claims that were grossly inadequate, materially substandard, or worthless services.”  In other words, Medicare and Medicaid paid claims for services that did not actually help patients living in these facilities.

In addition to fraud allegations, the owners face overmedication allegations.  According to the lawsuit, the facilities gave residents anti-anxiety medications and other drugs “at the convenience of management.”  The allegations suggest that the patients did not need these medications, but staff provided them in order to make their jobs easier.

Specific Claims in the Lawsuit

The lawsuit was filed in the U.S. District Court in San Francisco.  The damages sought are yet to be determined, but the owners face possible of civil penalties that range “from $5,500 to $11,000 for each violation.”

According to the lawsuit, seven different residents between the ages of 46-101 were victims of nursing home abuse and neglect.  The lawsuit claims these residents either suffered mistreatment or were the subject of the fraudulent Medicare and Medicaid claims.

One 86-year-old resident suffered from “sepsis, lethargy, dehydration, malnutrition, an infected pressure ulcer, additional pressure ulcers, and overall functional decline.”  According to the suit, the staff at the nursing home doubled the man’s daily dose of Xanax, a sedative, and also gave him two antipsychotic drugs—Haldol and Risperdal—“without the consent of his physician or family.”  It is also alleged that a resident who suffers from Alzheimer’s was overprescribed psychotropic drugs.

Contact a San Diego Nursing Home Abuse Attorney

Nursing home neglect can lead to severe and life-threatening injuries.  While pending legislation in California seeks to change the way we think about fines and violations for assisted-living facilities, many nursing home residents continue to sustain personal injuries due to elder abuse.  If you are concerned about an elderly loved one in a nursing home or assisted-living facility, do not hesitate to contact an experienced San Diego nursing home abuse lawyer.

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Sacramento Lawyer Charged with Elder Abuse

Behind the Medicare Star Rating System

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recent article in the Sacramento Bee reported on an attorney in the northern California area who was charged with financial elder abuse.  At the Walton Law Firm, we take elder financial abuse very seriously.  As an Elder Justice Advocate, Randy Walton is committed to protecting older Americans from crimes such the ones that occurred recently in Sacramento.  When looking for an elder lawyer to help with your legal issues, you should not need to worry whether you will be treated fairly. Contact our office today to learn more about our dedication to safeguarding elders in the San Diego area and throughout the state.

file000453200083Scams Target Elderly Californians

According to the Bee article, in late August, authorities arrested Delbert Joe Modlin, 63, on charges of financial elder abuse, grand theft, and securities fraud.  His release on bail conditioned that he agree not to practice law or see clients until the criminal proceedings ended.  Modlin has been licensed to practice law in California since 1987.
Modlin is accused of scamming a 90-year-old man from North Highlands and his 66-year-old daughter into investing substantial sums of money without any real promise of return.  According to court documents, he “advised the elderly man to liquidate all his investments, and he persuaded the daughter to invest $120,000 in a new cat litter box that Modlin allegedly had invented.”  He promised to double investments, but the father and daughter never saw their money again.

Hiring a Dedicated and Reputable Advocate

Much like records of nursing home abuse violations, it is important to know the background of potential caregivers or advocates.  Modlin failed to tell the elderly father and daughter he scammed that he was coping with a “severe gambling problem,” and that he twice filed for bankruptcy–one in 2004, and a second time in 2012.  According to one investigator on the case, this is information “that a reasonable prudent investor would consider significant.”

Perhaps more alarming than his financial history, Modlin is currently awaiting trial for felony charges in Placer County, California.  In 2011, authorities levied criminal charges against Modlin for “defrauding a frail, elderly couple from Auburn and selling their home and assets without their approval.”

The state of California wants to make sure elderly persons are not fooled by Modlin’s promise to help.  The state claims Modlin took steps to wipe away negative information about him on the Internet by hiring a firm to “clean his presence” and “manipulate search engines to obscure negative details.”

Elder abuse can happen anytime and anywhere, and those we trust to act in our best interest are not always trustworthy.  It is important to clearly understand the financial the histories of advisors and physical caregivers when planning to trust them with a elderly loved one’s well-being.  If you are concerned about fraud or nursing home abuse, contact a San Diego nursing home abuse lawyer at the Walton Law Firm today.

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Financial Elder Abuse Continues to Thrive in California

Online Map to Track Elder Financial Abuse

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History of the Star Rating System

A recent New York Times article discussed the danger of trusting the Medicare star rating system, providing as an example a five-star nursing home facility in California with a history of elder neglect violations. Last week, we discussed the star rating system and the Rosewood nursing home in the Sacramento area. In sum, the rating system is not helping consucohdranknmomprknsnsmers in the way it claims. How did this rating system rise to prominence, and why are so many Americans willing to trust it without additional investigation?

According to the article, the five-star rating system began in 2007, when Oregon Senator Ron Wyden posed the following question at a congressional hearing: why is it easier to shop for washing machines than to select a nursing home? Two years later, Medicare officials developed the  star rating system, “a move that was applauded by consumer groups, who hope that more transparency would lead to greater accountability.”

The nursing home industry initially “lobbied against the ratings,” but later embraced them after a number of facilities earned the coveted five star rating. Some industry trade groups even profited from the rating system. According to the article, the American Health Care Association “offers members a free service that helps companies track their star rating,” and the industry trade group insists that “the rising scores are evidence that quality is improving.” However, nursing home abuse continues, and older Americans continue to suffer serious injuries in facilities across the country.

Too Many Facilities Have High Star Ratings

Medicare officials believe the star rating system gives nursing homes an incentive to improve their quality. If quality of care increases, officials suggest, they can look forward to receiving a higher star rating. Dr. Patrick Conway, the chief medical officer at the Centers for Medicare and Medicaid Services, says the federal agency has “seen improvements.”

What improvements have Medicare officials catalogued? According to Conway, Medicare has observed:

  •      Decrease in the use of physical restraints by nursing homes, and
  •      Fewer nursing homes reporting bedsores “among patients at a high risk of developing them.”

Since a significant amount of this data comes from self-reporting, are nursing homes in the San Diego area and across the country really improving? In interviews with former nursing home employees and patient advocacy groups, the New York Times learned that many nursing homes and assisted living facilities “learned how to game the rating system.”  In that sense, too many facilities with above-average ratings continue to receive complaints of elder abuse and neglect.

When the program started in 2009, 37 percent of nursing homes in the U.S. received ratings of four or five stars. In the last five years, the number has risen substantially. Today, approximately half of all facilities receive these superior rankings. Five-star ratings alone increased from 11 percent in 2009 to 29 percent in 2013. As noted, many of these nursing homes, such Rosewood in Sacramento, received four or five stars based on self-reported data.

It is important to fully research a nursing home or assisted living facility before trusting its quality level. If your elderly loved one sustained injuries due to nursing home abuse or neglect, contact a dedicated San Diego nursing home abuse lawyer today to discuss your case.

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Medicare Star Ratings and Quality of Care

Assisted Living Facilities Fail to Pay Fines

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Five-Star Nursing Homes May Not the Best Indicator of Care

Are Medicare star ratings good predictors for the quality of care at nursing homes?  According to a recent article in the New York Times, a facility with a five-star rating may not be what one would expect.  In fact, many five-star facilities have receiIMG_29490008ved fines for injuries related to nursing home neglect.

Rosewood Post-Acute Rehab, a nursing home located in a Sacramento suburb, received a five-star rating from Medicare.  The nursing home “bears all the touches of a luxury hotel, including high ceilings, leather club chairs, and paintings of bucolic landscapes.”  According to the article, getting a five-star rating—the highest possible—is not easy.  Only about one-fifth of all nursing home in the U.S., about 3,000 total, hold this distinction.

Yet the star rating can be misleading to consumers.  Based on research conducted by the New York Times, a Medicare “seal of approval” is often based on incomplete information about the living conditions at these nursing homes.  The star ratings “are based in large part on self-reported data by the nursing homes that the government does not verify.”  Three criteria are used to determine Medicare star ratings, including:

  •      Staff levels;
  •      Quality statistics;
  •      Results of annual health inspections.

Only the third criterion—the results of annual health inspections—receives verification by independent reviewers.  The staff levels and quality statistics are based on data reported by the nursing homes themselves and taken at face value, “with limited exceptions.”

Negative Information Not Included in Star Ratings

It is problematic that the Medicare star ratings, known as “gold standards” in the industry, receive much of their information from nursing homes’ self-reporting.  Even more problematic, perhaps, is that the ratings do not “take into account entire sets of potentially negative information.”  What type of negative information gets ignored?  Generally, it is information about fines and enforcement actions taken by state authorities, or consumer complaints filed with state, rather than federal, agencies.

How does this play out in practice?  In the case of Rosewood, the State of California fined Rosewood $100,000 last year for “causing the 2006 death of a woman who was given an overdose of a powerful blood thinner.”  The penalty is the highest levied in California.

Rosewood did not only receive one fine, either.  Between 2009 and 2013, state agencies received hundreds of consumer complaints about Rosewood.  The State of California estimates it received 102 complaints, while the advocacy group California Advocates for Nursing Home Reform (CANHR) indicates that 164 consumers filed complaints against Rosewood.  If those numbers are correct, Rosewood received twice the number of complaints as the state average.

If your elderly loved one suffered an injury resulting from nursing home abuse or neglect, contact an experienced San Diego nursing home abuse lawyer today.

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