California Nursing Home Abuse Lawyer Blog

Earlier this month in Sacramento, a judge upheld a $23 million jury award in a case where an elderly woman died from bedsores, reported UT San Diego. This nursing home abuse occurred at a Northern California assisted living facility owned by the Emeritus senior living corporation. In addition to the original verdict, the judge actually added an additional $4.3 million in legal costs and fees, according to the Sacramento Bee.

This recent decision will have important implications in nursing home abuses cases in California. The high verdict sends a message to nursing homes and assisted living facilities in our state that they need to take better care of residents if they want to avoid lawsuits for nursing home abuse and neglect. If they don’t, they’ll have to pay. If you are concerned about an elderly loved in in a nursing home or assisted living facility, it’s important to speak to an elder justice advocate. Your loved one and your family may be eligible for compensation.

The Victim’s Story

Five years ago, an Alzheimer’s patient sustained bedsores while she resided at the Emeritus at Emerald Hills, an assisted living facility in Auburn, California. She later moved out of the assisted living facility, and she died only a few months later. According to the Sacramento Bee, the death certificate indicates that pressure ulcers had been a “substantial factor in her death.” The victim was 82 years old when she passed away.

The family brought a claim against the Emeritus senior living corporation, which is based in Seattle.

Details of the Case

Earlier this year, the victim’s family received a $23 million jury verdict for the death of their loved one. After that verdict on March 8, Emeritus sought either a reduction in the verdict amount or a new trial. In seeking to pay out less than the jury awarded, Emeritus claimed that the $23 million award was “far beyond the ratios suggested in established case law that ties punitive awards to a single-digit multiplier of the plaintiff’s actual damages.”

Yet, it seems that the jury’s award fell within the range of the multiplier. The jury awarded the victim’s family $3.875 million for her pain and suffering, which became the base figure for the punitive award. Compared to the punitive award, it looks like a ration of about 6 to 1, which falls within the appropriate range.

Punitive awards can be quite controversial. They’re not intended to “make a victim whole” as most legal remedies do, but instead they’re intended to punish the perpetrator for a particularly bad act. So, unlike compensatory remedies that compensate a victim for specific losses, there’s no particular number, or economic amount, to “repay” in an award of punitive damages. Unsurprisingly, Emeritus claims that the punitive award was too high in this case.

Emeritus says that the punitive award should have been capped at $250,000 based on a cap set by California state law for assisted living lawsuits and medical malpractice cases. However, the judge didn’t tell the jury about the cap, and she indicated that it’s not a hard and fast one. Rather, limitations on pain and suffering awards in assisted living cases should be “a question of first impression.” In cases like this one where Emeritus’ negligence was especially egregious, the judge suggested that a multi-million dollar award was appropriate.

If you suspect that an elderly loved one has suffered from neglect in a nursing home or assisted living facility, contact an experienced nursing home abuse lawyer today to discuss your case.

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Jury Awards $42 Million in Nursing Home Bedsore, Dehydration Case

Caregiver Charged with Crime for Bed Sore Related Death

A recent article in The New York Times suggested that banks may play a key role when it comes to schemes intended to defraud older Americans. Is elder financial abuse a significant problem, especially when many people in the U.S. are dealing with money troubles despite their age?

Financial Elder Abuse

According to The New York Times, older Americans may be particularly susceptible. When it comes to financial fraud, elderly persons tend to be more vulnerable due to their increased financial worries and loneliness. If you are concerned that an elderly loved one has become the victim of financial abuse, you need an experienced elder justice advocate on your side.

While anyone can become a victim, older adults may spend more time at home by themselves and may be more likely to respond to “deceptive pitches that arrive by telephone, mail and the Internet.” And what’s worse is that certain banks have allowed this financial abuse to occur, while some have even benefited monetarily.

Banks as “Quiet Enablers” of Financial Fraud

In recent filings connected to civil suits against Zions Bank of Salt Lake City and First Bank of Delaware, federal authorities indicated that these so-called reputable banks actually played a key role in permitting the fraudulent transfer of money from the accounts of older adults into the hands of scam artists.

For example, Bruno Koch, 83, answered a call from a telemarketer who asked if he’d like to “update his health insurance card.” Naturally, Mr. Koch said yes, he would, and then proceeded to provide that telemarketer with crucial information concerning his bank account. Soon after, Mr. Koch noticed money missing from his account from unauthorized charges, and he never received a new health insurance card. Mr. Koch became a victim of what is known as “mass market fraud.”

He banked with Zions, and as it turns out, the bank actually “served as a gateway between the dubious Internet merchants and their marks,” such as Mr. Koch. The bank also “made money for itself in the process.”

How does this happen? Banks such as Zions collect fees for transactions that seem questionable, but they ignore “warnings of potential fraud,” and in some cases they even “enable dubious merchants to prey on consumers.” The Times describes these banks as “financial conduits and quiet enablers for questionable businesses.” In some cases, banks such as Zions permit billions of dollars of fraud in any given year.

Holding the Banks Accountable

In response to the harmful bystander roles that these banks continue to play, the Justice Department has decided to “take aim” at financial institutions that enable predatory lending and mass market fraud. Michael Blume, the director of the consumer protection branch at the Justice Department, said that he operates under the assumption that banks “can’t close their eyes” to fraud that’s happening under their noses, and if they do, they’ll be held legally responsible.

First Bank of Delaware recently reached a $15 million settlement with the Justice Department after it allowed “merchants to illegally debit accounts more than two million times and siphon more than $100 million.” According to court records, Zions allowed about $39 million to be debited “from hundreds of thousands of accounts,” and the Justice Department intends to hold the bank similarly accountable.

If you suspect that an elderly loved one has been the victim of financial fraud or financial abuse, an experienced attorney can discuss your case with you today.

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To Protect and Defraud?

Back in 2011, a Miami Herald investigation uncovered evidence of elder abuse and neglect in assisted living facilities across the state of Florida. Since then, politicians have been working to pass legislation to reform assisted living facilities in Florida. However, according to an article in the Miami Herald, the bill failed to pass again on the last day of the legislative session in Florida.

While this legislation (or the lack of it) would primarily affect residents in Florida, the state’s concerns about abuse and neglect in assisted living facilities are just as relevant here in California. Do you have a loved one who is currently in an assisted living facility? If you’re concerned about abuse and neglect in nursing homes or assisted living facilities in southern California, contact an experienced nursing home abuse lawyer today to discuss your case.

History of the Legislation

The investigation, which prompted legislators to take action for reforms, discovered that “at least 70 residents of assisted living facilities had died from abuse and neglect since 2002.” In response to this report, Florida Governor Rick Scott “vowed to make improvements.” While he did form a task force in 2011 that “developed forceful reforms,” during the 2012 legislative session the House and the Senate were unable to agree to any reform measures based on the recommendations of that task force.

In April 2013, the Florida Senate passed SB 646, a bill introduced by Senator Eleanor Sobel that proposed a new set of reforms related to assisted living facilities in the state. The bill would tighten state “oversight of Florida’s nearly 3,000 assisted living facilities.” In the Senate, the bill passed unanimously with a 38-0 vote. However, no companion measures gained popularity in the Florida House of Representatives.

In hopes of getting the House to pass the Senate bill, Sobel added the reforms from SB 646 to an omnibus healthcare bill that had been sponsored by Senator Aaron Bean. However, the omnibus healthcare bill “was later weighed down with dozens of amendments.” As a result, the bill was never heard. The Florida Senate session notes reported that the bill “died in the House.”

Jack McRay, the AARP Florida advocacy manager, told the Miami Herald that he was “hugely disappointed” that the bill didn’t pass. “In the next go-around,” he said, “the Legislature ought to focus more on protecting residents of assisted living facilities than protecting the industry.”

What Reforms Did the Legislation Propose?

According to the Miami Herald, the reforms proposed in Sobel’s bill were actually less stringent than those proposed in 2012, although it still contained importation regulations “to help protect residents.” Given that the bill “wasn’t as tough as last year’s effort,” it’s surprising that the bill still failed to pass.

Specifically, SB 646 would have required “more standard inspections,” and it would have required specialty licenses for assisted living facilities housing at least one mental health patient. In addition, it would have required that those facilities draw up specific plans for its residents’ mental healthcare.

In conjunction with licensure requirements, the bill would have created a rating system for assisted living facilities, as well as a consumer guide. And in order to penalize facilities that failed to maintain certain standards, the bill also would have led to “more equitable fines for violations,” meaning that larger facilities would pay larger fines than the smaller ones. According to the executive director of the Florida Assisted Living Association, the bill could have led to positive changes in the state.

Advocates in Florida plan to continue moving for assisted living facility reforms in the state. But it’s important to keep in mind that elderly abuse and neglect occurs across the United States, and California residents are also at risk. If you or a loved one have suffered abuse or neglect while in a nursing home or assisted living facility, you may be eligible for compensation. Contact us today to discuss your claim.

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Staffing Shortages Can Lead to Nursing Home Abuse and Neglect
January 1 = Stricter California Elder Abuse Reporting Laws

A recent article investigating nursing home abuse and neglect claims in New York could have significant implications in southern California. According to the Post Star, nursing home understaffing looks to be a major cause in nursing home neglect cases, along with medical training deficiencies and state inspection errors.

Local Felony Charges Due to Understaffing?
Last summer, Tiffany Vanalen, a licensed practical nurse with more than 10 years of experience, was arrested on felony neglect charges. The Post Star reported that she hadn’t intended to harm anyone at the Pleasant Valley nursing home where she had been employed, yet a state investigation showed that Vanalen failed to give required medications to five residents at the nursing facility, and then she proceeded to falsify documents to make it look like she had, in fact, given the medications.

Vanalen’s lawyer, George Lamarche, argued that his client “was a victim of circumstance” because she had been working at a nursing home with a high employee turnover rate and growing public scrutiny. He indicated that “understaffing could be a problem,” and that “too many patients assigned to a single nurse could be a problem.” Emphasizing that the charges faced by his client may never have arisen if the nursing home had hired more nurses and staff members, Lamarche said that “the sad thing” about the situation is that Vanalen had been “singled out and targeted.”

In addition to the charges against Vanalen, state investigators discovered a number of other problems at the nursing home where she worked. For example, the New York Department of Health “found bloody rags in the kitchen” and “drugs going to the wrong patients.” Vanalen’s original 15 felony charges have since been reduced to “a handful of misdemeanors,” and she has yet to go to court.

The Post Star took Vanalen’s side, describing her story as one “that repeatedly plays itself out with different actors and similar results throughout the nation.” The article emphasized that nursing home staff members often are “already stressed by an ongoing privatization effort” while also dealing with strikingly low wages and long hours.

Federal Report Confirms Understaffing Woes
Last year, a Congressional report confirmed many of the claims in the Post Star article. According to ABC News, “many nursing homes are so understaffed they may be endangering the welfare of their patients.” In order to deal with understaffing problems, federal health officials recommend stricter guidelines for the number of staff required at nursing facilities. And these guidelines may not pose a huge burden on these facilities. For example, nursing homes could be required to simply hire more nurses and nurses’ aides.

The report indicated that understaffing has, at the very least, contributed to a number of nursing home abuse issues, including “severe bedsores, malnutrition, and abnormal weight loss.” In order to combat these problems, the U.S. Department of Health and Human Services recommended that each patient should receive at least two hours of care per day from an aide.

Emphasizing that more than half of nursing homes in our country fall below these seemingly meager requirements, ABC News suggested that increased medical attention, even by a limited number of minutes each day, might prevent a large number of incidents of nursing home abuse. And these statistics are relevant across the country—from the New York issues surrounding Tiffany Vanalen’s charges to the many nursing facilities in California.

If you suspect that your elderly loved one has experienced nursing home abuse or neglect, it’s important to speak to an experienced nursing home abuse attorney. Contact us today to discuss your case.

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Many older adults who experience depression may see their risks for developing Alzheimer’s and dementia increase, according to a recent article in the New York Times. This is a serious issue for patients in nursing homes and other elder care facilities. While elder abuse and neglect can take many forms, the failure to provide for a patient’s mental needs, such as depression, may constitute neglect.

Statistics on Depression and Alzheimer’s Disease

The New York Times article reported that current research suggests that “late-life depression” has not only led to increased risks for “social isolation, poorer health, and an increased risk of death,” but it also may lead to Alzheimer’s disease and other forms of vascular dementia. With an increasingly large population of older adults, these facts are concerning.

In fact, according to research published in the British Journal of Psychiatry, depressed older adults aged 50+ “were more than twice as likely to develop vascular dementia and 65 percent more likely to develop Alzheimer’s disease” than other similarly aged adults who didn’t suffer from depression. These numbers are the result of a study that included nearly 50,000 older adults over an approximately five-year span.

What do the numbers mean in terms of how many people will develop dementia? The numbers suggest that “36 of every 50 older adults with late-life depression may go on to develop vascular dementia,” and “31 of every 50 seniors with a history of depression may eventually be diagnosed with Alzheimer’s.”

This news shouldn’t come as a complete shock, since a 2012 study in General Psychiatry reported similar findings. In that study, researchers at the University of California at San Francisco found that people with depression during the ages of 40 to 55 seem to have an increased risk of developing dementia by about 20 percent, while those who suffer from depression at age 55+ appear to increase their risk of developing dementia by about 70 percent. For adults who suffered from depression in both midlife and late-life stages, their risk of developing dementia was reported to increase by nearly 80 percent, compared with others who showed no signs of depression.

These numbers all seem staggering. Should nursing homes and other elder care facilities be more attuned to depression and its dangerous effects?

Does Depression Cause Alzheimer’s?

The British Journal of Psychiatry study emphasized that there is no causal relationship between depression and dementia, and that there’s “no solid evidence yet” that treating depression early on can reduce your risk of developing Alzheimer’s disease later in life.

However, while the researchers emphasized that they can’t say for certain that late-life depression is a direct cause of Alzheimer’s and vascular dementia, they can certainly say that it’s a factor that contributes to these diseases. In fact, Meryl Butters, an associate professor of psychiatry at the University of Pittsburgh School of Medicine, said that “depression is toxic to the brain, and if you’re walking around with some mild brain damage, it will add to the degenerative process.” In short, increasing the quality of life for older adults can be beneficial to their long-term physical and mental health.

In particular, these findings suggest that mental health care for older persons in nursing homes and assisted living facilities can be extremely important. If you suspect that a parent or elderly loved one has been the victim of elder neglect, an experienced nursing home attorney can discuss your case with you today.

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A recent article in the New York Times discussed certain dangers that can await Parkinson’s patients when they’re admitted to hospitals. These patients require specific medications at certain times, and general hospital staff members aren’t educated about the needs that these patients have. As a result, Parkinson’s patients can be the victims of serious medication errors, and they can undergo severe side effects from seemingly routine hospital visits.

If an elderly parent or loved one has been mistreated while in the hospital, an experienced elder justice advocate can discuss the details of your case with you today.

Dangerous Consequences of Medication Errors

The New York Times provided an example of a specific Parkinson’s patient whose medication needs weren’t fulfilled while in the hospital for what was supposed to be “a short stay.” Roger Anderson, who has Parkinson’s, was supposed to have surgery “to relieve a painfully compressed spinal disk.” Anderson and his wife assumed the staff at the hospital in Portland, Oregon would know how to care for him.

Because he has Parkinson’s, Anderson must take certain medications “at precise intervals to replace the brain chemical dopamine, which is diminished by the disease.” His wife emphasized that there isn’t “much of a window” in administering these medications. She explained that, “if you have to wait an hour, you have tremendous problems.” When Parkinson’s patients don’t receive these drugs, they can “freeze” or be unable to move. In addition, they may develop “uncontrolled movements called dyskinesia,” and they can be more “prone to falls.”

However, the Portland hospital staff didn’t understand the severity of the situation, and the hospital rules prevented Anderson’s wife from administering these medications to her husband. As a result, serious medication errors occurred. With his disrupted medication schedule, combined with the stress of surgery, anesthesia, and a wound that became infected after surgery, Anderson was forced to stay in healthcare facilities for nearly three months. In fact, he developed delirium, had a fall, and ultimately lost 60 pounds. He managed to recover and return home, but his disease has since progressed, according to his wife. Unfortunately, Anderson’s experience seems to be the norm.

Are All Parkinson’s Patients At Risk During Routine Hospital Visits?

According to the National Institute of Health (NIH), older people with Parkinson’s tend to be hospitalized more frequently than other people their age, and often their hospital stays last longer, too. While all elder persons are going to face more dangers during routine hospital stays, neurologists believe that people with Parkinson’s tend to have “particularly hazardous” experiences in hospitals. Dr. Michael Okun, a neurologist at the University of Florida and the national medical director for the National Parkinson Foundation, explained that Parkinson’s is typically a disease that affects older adults, and they’re at greater risk for medication errors “even in good hospitals.”

Primarily, Okun emphasized that Parkinson’s patients “aren’t getting their meds on time, and they’re not getting the right meds.” And what’s worse is that many commonly prescribed drugs during routine hospital stays are actually dopamine blockers. For older patients with Parkinson’s, these drugs can have dangerous interactions and can cause severe results. The New York Times emphasized that “not everyone is as lucky as Roger Anderson.”

This is a serious issue facing older adults. There are some steps you can take to minimize the danger of hospital stays, including getting ahold of a free “Aware in Care” kit that includes a hospital bracelet to identify its wearer as a patient with Parkinson’s. However, many elderly people slip through the system. If an elderly parent or loved one has experienced medication errors while in the hospital, they could be entitled to compensation. Contact an experienced elder law attorney today to discuss your concerns.

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A West Virginia jury awarded $90.5 million in damages to a family who alleged nursing home abuse and neglect back in 2010. The nursing home has taken the case to the West Virginia Supreme Court once already, according to an article in West Virginia’s State Journal. And this time, they’re arguing that the state’s Medical Professional Liability Act (MPLA) should require the court to apportion damages in their favor.

This case could have important implications for nursing home abuse damages in California. While the West Virginia Supreme Court’s ruling won’t bind California courts, it may set the tone for the ways in which damages are approached and apportioned in nursing home abuse cases.

Details of the Nursing Home Neglect

In 2010, 87-year-old Dorothy Douglas died while in the care of a West Virginia nursing home. That same year, Tom Douglas, the victim’s son, filed a claim against Manor Care Inc., HCR Manor Care Services Inc., Healthcare and Retirement Corp. of America LLC, and Heartland Employment Services LLC. He alleged that his mother died because of severe dehydration and malnutrition while in the nursing home.

The nursing home argued instead that Dorothy Douglas died as a result of her dementia, and not from dehydration or malnutrition. The nursing home explained that she had been transferred to a hospice facility 18 days before her death due to her dementia-related health decline.

Jury Awards Whopping Verdict for Tom Douglas

When the case went to trial in Kanawha County Circuit Court, the jury awarded Tom Douglas (and his family) $91.5 million. In so doing, it found that the nursing home had been “responsible for ordinary and medical negligence,” and that it violated its fiduciary duties and portions of the Nursing Home Act in the state.

The jury awarded $11 million for the death itself, or compensatory damages, and $80 million in punitive damages. Punitive damages aren’t typically awarded to compensate the victim in a case, but rather to deter the defendant from engaging in this kind of conduct in the future. In many ways, punitive damages are a way for the jury to punish a defendant who has committed an especially bad act. Due to statutory caps on certain damages, the Kanawha County circuit judge reduced the award to $90.5 million.

The Nursing Home’s Appeals

The nursing home appealed to the West Virginia Supreme Court for a write of prohibition, arguing that there had been an error in the jury verdict form. If granted, a writ of prohibition could prevent enforcement of the Kanawha County Circuit Court’s order, which didn’t include this specific jury verdict form on the record. The West Virginia Supreme Court found in favor of the nursing home, allowing them to add their proposed verdict form to the record.

Now, the nursing home is appealing to the West Virginia Supreme Court again, but this time to reduce Douglas’s damages. The nursing home contends that the MPLA “supercedes the Nursing Home Act.” At the original trial, Douglas argued that damage caps through the MPLA wouldn’t apply because the majority of the jury’s damages were for ordinary negligence, and not medical negligence specifically. However, if the MPLA were to be applied in this case, the medical negligence damages would have to be capped at $594,000. This is significantly less than the jury’s original award. The nursing home makes a few other claims as well, including that damages were incorrectly awarded to Douglas’s daughter, who wasn’t named as a party in the lawsuit.

While we’ll have to wait to see how the West Virginia Supreme Court decides, experienced nursing home abuse attorneys are available to speak to you today about nursing home neglect and abuse in California. If you or an elderly loved one have been neglected or abused in a nursing home, you may be eligible for compensation. Contact us today.

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A recent study in JAMA Internal Medicine confirmed that abused and neglected elderly persons face much higher risks for hospitalization, and not necessarily for injuries suffered as a result of their mistreatment. According to Dr. Theresa Soriano, an associate professor of medicine in geriatrics and palliative care in the Icahn School of Medicine at Mount Sinai, “It is understandable how a vulnerable older person experiencing abuse may fail to prioritize the prevention or care of their health conditions.”

Hospitalization rates especially tend to increase when elderly persons rely upon an abusive family member as a caregiver. They can miss medical appointments, adhere poorly to required diets and medication schedules, and they can experience increased stress and anxiety. As a result, all of these things can contribute to “poor control of any medical conditions and increased hospitalizations,” according to an article in Health magazine.

Details of the Study
The recent study analyzed information from more than 6,500 older adults who participated in the Chicago Health and Aging Project. Dr. XinQi Dong from Rush University Medical Center and Dr. Melissa Simon from Northwestern University Medical Center led the study.

They gathered reports from various social service agencies to identify 106 elder persons who were victims of abuse between 1993 and 2010. The researchers then reviewed hospitalization rates compiled by the U.S. Centers for Medicare and Medicaid Services, and they found that “the annual rate of hospitalization was more than doubled for those who reported elder abuse versus those who did not.”

When drawing final conclusions, the researchers determined that all kinds of elder abuse can affect hospitalization rates—not just physical abuse and neglect. In fact, they concluded that “elderly people who suffered psychological abuse, financial exploitation, caregiver neglect, or two or more types of abuse were hospitalized more frequently than those without reported elder abuse.”

With hospitalization rates increasing for older adults, should we be asking if elder abuse is a growing problem in the U.S.?

Experts Suggest Elder Mistreatment is a Growing Problem
In addition to the medical experts who conducted the study for JAMA Internal Medicine, other experts in the field also worry that elder abuse leading to higher hospitalization rates is a problem that isn’t going away.

According to Dr. Gisele Wolf-Klein, the director of geriatric education at the North Shore-LIJ Health System in New York, about 10 percent of elderly persons in America are victims of abuse, and “the trend is increasing.” In fact, Wolf-Klein indicated that psychological abuse may be a primary culprit for hospitalization.

What can we do? The important thing is to spot elder abuse early and to report it to social services agencies. While this can be a challenge for many reasons, early reporting can help to reduce the rates of elder hospitalization. And Wolf-Klein suggests that some caregivers may be relieved to have assistance from social services agencies. “The ultimate goal for our society,” she explains, “is to enable these social services agencies to provide overwhelmed caregivers of older adults with the support they need on a daily basis, in order to successfully manage the complex demands of frail patients totally dependent on others.”

If you suspect that an elderly loved one has been a victim of elder abuse or neglect, contact an experienced attorney today to discuss your case.

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Quality of Life

Just last week, a South Dakota court granted a nursing home abuse defendant access to the victim’s medical records, according to a news release from the Nursing Home Abuse Center. Heather Lynn Laird, a 36-year-old former employee of the Dell Rapids Nursing and Rehab Center, was indicted last December for felony abuse and neglect of an elderly person. Now, Laird and her attorney have the right to view the victim’s medical records. Laird and her attorney hope that these medical records will prove relevant in the defense.

In January, Laird pled not guilty to the charges against her. Yet her record as a licensed practical nurse (LPN) suggests that this isn’t the first complaint.

Defendant’s History as an LPN Caregiver
In late 2012, the South Dakota Board of Nursing issued an order for summary suspension to temporarily suspend Laird’s nursing license until a hearing to determine whether she could continue to practice as an LPN in the state.

The Board issued this suspension after receiving a complaint from the long-term care facility where Laird had been employed. The complaint indicated that, on “at least five separate occasions,” Laird had been “rude and harsh in her dealing with residents.” In addition, the complaint alerted the Board that Laird “was rough with residents and used profanity toward them.” In each of these cases, Laird’s employer reprimanded her for these incidents and eventually fired her last July.

When the Board receives a complaint like this one, it meets with the accused as part of the investigation. Laird denied all of the accusations. The Board continued its investigation, but before it could meet to make a decision about the status of Laird’s LPN license, it received another complaint from the Dell Rapids Nursing and Rehab Center. This complaint concerned the case for which Laird has been charged with felony abuse and neglect of an elderly person.

Details of the Dell Rapids Case
According to the order issued by the South Dakota Board of Nursing, the complaint from Dell Rapids Nursing and Rehab Center concerns an altercation in which Laird attempted to administer medication to a resident by force. The resident is the alleged victim in the current case against Laird.

In the early morning of November 3, 2012, Laird went into the victim’s room and woke her up to administer medication. When the victim seemed surprised, Laird “forcefully tried to get the medication into her mouth.” When she tried to sit up, Laird allegedly used her knee to hold the victim down, and proceeded to throw water in her face. Laird then “grabbed the resident’s breast and squeezed it tightly, causing a noticeable bruise.”

According to ArgusLeader.com, Laird’s lawyer indicated that if the victim’s medical records show signs of dementia or Alzheimer’s, they could be helpful in Laird’s defense to prove that the victim had been aggressive. And these questions of mental health might extend to the victim’s husband, as well. Laird and her attorney indicated that the husband has a history of violence, and they claim that he might have caused the bruising on the victim.

Judge Patricia Riepel granted Laird’s request for access to the victim’s medical records, explaining that this kind of information is essential to provide at this stage of a case, since both parties are still in discovery.

If you are concerned about an elderly loved one’s safety in a California nursing home or long-term care facility, contact an experienced nursing home abuse attorney today.

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Last month, a California nursing home abuse case was delayed when the defendant requested extra time to weigh her options for a plea deal. The California Attorney General charged Sylvia Cata with involuntary manslaughter for the death of a dementia resident in her care. Do you have a loved one in a nursing home or a private care facility? This case raises questions about the level of oversight from the California Department of Social Services (CDSS).

History of the Case
Cata operated “Super Home Care” out of her own home since the mid-1990s. According to an article in the Sacramento Bee, Cata’s home was located on “a dead-end street in Sacramento’s Gardenland neighborhood, a residential enclave flanked by tire shops, lube and oil joints, and a check-cashing store on the corner.” This description doesn’t sound like an ideal site for an elder-care facility, and the CDSS suspected as much.

For most of the years that Cata’s business operated, the CDSS “expressed exasperation and dismay” with her work. As a result, Cata’s in-home operation underwent a number of complaint investigations, and it was also subject to “deficiency reports, citations, fines, and plans of correction.”

In fact, between 1996 and 2012, Cata received 40 citations for failing to follow California requirements for nursing home operation, according to a report from the Nursing Home Abuse Center. Of those 40 citations, 26 were Type A deficiencies, which are “the most serious violations under state regulations.” They’re issued when there are “direct and immediate risks to residents’ health, safety, or personal rights.” Yet, despite these serious citations, Super Home Care remained open and Cata kept her license until the 2012 death of a resident finally shut its doors.

Details of the Case
Cata’s involuntary manslaughter charge arises from the death of an 88-year-old resident in her care, Georgia Holzmeister. Holzmeister suffered from dementia, and she had been living at Super Home Care for more than five years. During the final days of her residency, Holzmeister developed a “Stage IV bedsore” during spring 2012. When Cata finally called emergency medical services that June, Holzmeister was unconscious. The patient was transported to the hospital where she received emergency treatment, but she never regained consciousness. Five days after being admitted to the hospital, Holzmeister passed away.

In February 2013, California’s attorney general charged Cata with involuntary manslaughter. The Sacramento Bee reported on the seriousness of the charge, indicating that this was “a first for state prosecutors in an elder-care case.” In addition to the involuntary manslaughter charge, the attorney general also charged Cata with “a second felony count of elder or dependent adult abuse, resulting in death.” With the latter charge, Cata could face up to 12 years in prison.

The attorney general issued felony charges based on Cata’s “deliberate and complete reckless disregard for performing the essential duties as Holzmeister’s caretaker.”

In addition to targeting Cata for her poor patient care, the attorney general and the state of California also hope to illuminate the ways in which the CDSS erred. Cata’s facility was classified as a “Residential Care Facility for the Elderly” (RCFE), meaning that it was licensed to house up to 6 residents and was regulated by the CDSS’s community care licensing division. Due to budget constraints, the community care licensing division tends to conduct approximately one unannounced inspection every five years, and it currently oversees approximately 7,500 RCFEs. Many advocates believe that Holzmeister’s death could have been prevented with better CDSS oversight.

If you have a loved one in a nursing facility, and you’re concerned about abuse, contact an experienced nursing home abuse attorney today to discuss your case.

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Do you have a loved one who is suffering from Alzheimer’s or another form of dementia? According to a recent article in the New York Times, dementia care costs are projected to double by the year 2040. This story comes just a few days after a new report in The New England Journal of Medicine that measured the monetary costs of dementia in America.

What do these new figures mean for nursing home costs and long-term care facilities in the San Diego area? While experts can’t make definitive predictions, many researchers fear that “it’s going to swamp the system,” creating more elderly persons in need of care than there are available caregivers and facilities.

How the Study was Conducted
The study found that the financial burden to care for those suffering from dementia is “at least as high as that of heart disease or cancer, and is probably higher.” The more salient information in the report is that “the number of people with dementia will more than double in 30 years, skyrocketing at a rate that rarely occurs with a chronic disease.”

This research was conducted by the Health and Retirement Study (HRS), which is a “nationally representative longitudinal survey of persons 51 years of age or older” that began its work in 1992. HRS catalogued the results from research conducted by the Aging, Demographics, and Memory Study (ADAMS), which is a “nationally representative study of dementia in the United States.” It assessed 856 HRS respondents, who underwent an “in-home clinical assessment for dementia,” which lasted for about 3-4 hours per person. The study considered whether these respondents were experiencing key symptoms of dementia, including their ability to perform activities of daily living (ADLs).

After determining the level of dementia for the respondents, HRS worked to measure the cost of care for each of these patients. The study attempted to include all forms of spending that occur when a person suffers from dementia, including out-of-pocket spending, spending by Medicare, net nursing home spending, and other varieties of formal and informal home care. According to the language of the study itself, “someone with a probability of dementia . . . would be expected to incur $33,329 more in health care costs than someone whose probability of dementia was zero.” In other words, the study found that the approximate cost for each dementia patient averages out to more than $33,000.

Cost Implications for Nursing Homes and Our Health Care System
It’s important to keep in mind that this $33k number is a low-end figure. In fact, most nursing homes indicate that they tend to spend between $41,000 to $56,000 per dementia case.

Right now, approximately 15 percent of people who are aged 71 or older suffer from dementia. That’s about 3.8 million Americans. Since the study found that the number of people with dementia is expected to rise to nearly 9.1 million by the year 2040, that means an increase in dementia-related health care costs by at least $175 billion by 2040. In all likelihood, health care spending will actually rise to anywhere between $279 billion to $511 billion—a sharp increase from the $159 billion to $215 billion reported in 2010.

One of the key issues for dementia-related spending in the coming years will be “helping patients in nursing homes” to “manage the most basic activities of life as they become increasingly impaired,” both cognitively and physically. In response to the figures reported by The New England Journal of Medicine, other researchers continue to assess the likely economic impact of the predicted increase in dementia cases. But the New York Times reminds us that this economic cost doesn’t reflect the “emotional cost” of dementia, which can be much higher.

If you have questions about nursing home care in the Southern California area, contact a licensed attorney today.

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San Diego Care Center Cited for Patient’s Choking Death
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[Image courtesy of Wikimedia Commons]

The California Department of Public Health (CDPH) cited the San Diego care facility Villa Rancho Bernardo Care Center (Center) for inadequate elder care, which resulted in the death of one of its residents. According to a story from NBC San Diego, the Center received the most severe penalty under state law, a “AA” citation that is accompanied by a $100,000 fine from the State of California. This isn’t the first time the Center has been cited by the CDPH. In fact, a previous citation occurred only a few years ago. Is this care center safe for patients?

What Led to the Recent Citation?
The Center had specific physician’s orders for a 61-year-old dementia patient’s diet. The patient had been admitted to the facility with a diagnosis of dementia, and his physician’s orders later stated that he had cognitive/behavior impairment (or decreased mental status).

As a result of his diagnosis, the patient required a “special chopped diet” that entailed having his food cut into very small pieces every day. According to a healthcare services manual, a “mechanical chopped diet” such as this one requires that meats be chopped “to the consistency of small dice,” or approximately ½ inch. This special diet had been prescribed because the patient had exhibited past behaviors in which he’d grab food and immediately stuff it into his mouth.

On October 31, 2012, the staff at the Center failed to have the patient’s food chopped, and the patient was served two pancakes and two uncut sausages. The patient proceeded to put all four of these food items into his mouth, and he then choked and died. The CDPH report described the Center’s negligence as the “direct proximate cause of the death of the patient.”

How Did This Happen?
According to the report, a series of people failed to notice the dietary error including: the cook, the dietary line checker, the licensed nurse, and the certified nursing assistant. None of these staff members verified “that the prescribed diet, in the correct consistency, was checked prior to bringing the meal tray into [the patient’s] room.”

The incident violated the Center’s policy on “Choking Prevention,” which states that, prior to serving meal trays to its residents, the licensed nurse assigned to the dining room is required to check that each meal matches the “diet slip” provided by each resident’s physician. Then, the Certified Nursing Assistant (CNA) is required to “double check” the tray after the licensed nurse checks it. The CNA does this in order to check “for any missed items or wrong diet” that the licensed nurse may have overlooked.

While the report doesn’t indicate how the licensed nurse and the CNA both failed to identify the problem with the resident’s meal, the CDPH is holding the Center accountable. And this isn’t the only case in which the Center has failed to provide adequate care.

History of “AA” Citations at the Center
In February 2010, less than three years before the choking death of the patient discussed above, the Center received another “AA” citation and $100,000 fine for the death of another dementia patient, who also suffered from psychosis. According to that report, the resident “sustained fatal head injuries after falling down a concrete stairwell” outside the Center. The resident, who was confined to a wheelchair, opened an emergency door and “fell down 20 concrete steps” while he was “still restrained in his wheelchair.” At the time of the fall, he was completely unsupervised. He died two days later from the injuries he sustained during the fall.

If you have an elderly loved one who has sustained injuries due to nursing home neglect, an experienced attorney can discuss your case with you. Contact us today.

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