Nursing Home Abuse and Neglect Blog

When entering a nursing home, residents or their family are usually presented with a stack of documents that address everything from the fees to be paid to the type of pillow the resident prefers. More than a dozen signatures can be required to complete the admissions process. Often buried within that stack is an arbitration provision, a binding contract wherein the resident agrees that any disputes over nursing home malpractice, negligence, neglect, or abuse will not be resolved in the courts, but via private arbitration. Private arbitration is simply a process where allegations of neglect or abuse are resolved by a private judge (frequently a lawyer) and not a jury.

Last week, the American Association of Justice, the United State's largest trial bar, announced its support for legislation titled The Fairness in Nursing Home Arbitration Act, which allows the decision to arbitrate to be made after a dispute has arisen, not before in the admissions process.

According to the AAJ, the passage of this act will prevent corporate nursing home owners from manipulating the arbitration system in their favor and at the expense of nursing home residents.

Nursing home residents should not be forced to check their legal rights at the door in deference to large corporate interests", said American Association for Justice President Kathleen Flynn Peterson. "Mandatory arbitration denies nursing home residents access to the civil justice system and stands in the way of the quality long term care they deserve. By forcing people into a costly private system, the corporation sets the rules and hand-picks the players.

I can say with experience that most people learn for the first time that they have waived their rights to a court action in favor of arbitration when they contact our office with claims of nursing home negligence. They are usually not happy about it. And clients get more upset when they learn that they have to pay for a portion of the arbitrator's fee, which usually exceeds $250 per hour. Imagine an elderly victim of neglect or abuse being told that he or she has to pay thousands of dollars simply to seek access to justice. Now you're getting the picture of what arbitration is all about.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Arbitration Agreements , Nursing Home Abuse and Neglect

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In California, approximately 200,000 claims of elder abuse are investigated every year by California social services. Because of proposed cuts to the California state budget, the ability to investigate claims of neglect or abuse could be reduced dramatically at a time when a greater portion of our population will be considered "elderly."

The director of the Center of Excellence in Elder Abuse and Neglect at UC Irvine is watching closely whether 75 social worker positions will be cut in the upcoming state budget. Mary Twomey stated that such a reduction in the investigation work force could translate into 20,000 allegations of elder abuse or neglect that will go uninvestigated.

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Posted In: Nursing Home Abuse and Neglect

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Dehydration in the nursing home can lead to significant complications, including death. If the human body is deprived of necessary fluids, several symptoms may appear, including an increased heart rate, decreased sweating, decreased urination, extreme fatigue, headaches, cramps, and tingling of the limbs.

The causes of dehydration are several. The most common is vomiting, diarrhea, malnutrition, or the simple failure to replenish the body with the liquids that are lost from sweating and urinating. Sadly, this is the most common cause of the dehydration in the nursing home.

Nursing homes have a legal duty to provide adequate hydration to their residents, and to provide the proper training to their employees to recognize the signs and symptoms of dehydration. The aging process itself will often cause a decrease in appetite, but this is never an excuse for dehydration in a patient (even though it's an excuse frequently used by nursing homes). For patients at risk, nursing homes are required to monitor the food intake and urine output of its residents, and keep the medical doctor informed of the resident's condition. The failure to do this may be a violation of the standard of care.

If you have any questions about dehydration in the nursing home or residential care setting, call Walton Barber LLP at (866) 607-1325.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Dehydration , Nursing Home Abuse and Neglect , Residential Care Facilities

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Living in a nursing home or assisted living facility continues to get more and more expensive. For a fifth consecutive year, the average annual cost for a private room in a nursing facility rose to $76,460. The costs varied dramatically state by state.

The costs for living in an assisted living facility also rose dramatically. Nationally, the average annual costs of living in an assisted living or residential care facility averaged $36,000, up 25% since 2004.

Experts believe that the costs of living in a nursing or residential facility will continue to rise if a shortage of long-term care workers is not resolved. As baby-boomers approach retirement, most have not adequately addressed the prospect of needing long-term nursing care in old age. The average person spends approximately 2.5 years in a nursing home, at a cost of over $190,000. Just a year or two in a nursing home can wipe out a persons lifetime of savings.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Assisted Living Facilities , Nursing Home Abuse and Neglect , Residential Care Facilities

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Police have arrested an Escondido couple for cheating elderly victims throughout San Diego County in a financial scam that garnered $1.5 million. According to police, Janet and Ronald Reiswig cheated 30 people in the county, most of them senior citizens. The Reiswigs have been charged with 79 criminal counts, including elder abuse and fraud.

According to reports, the couple advertised a certificate of deposit investment product that they claimed would return between 7 and 7.5%. In meetings at their offices, the Reiswigs persuaded their mostly elderly clients to write checks that they promised would be invested. They weren't. Instead the victims were sent phony CDs from the Reiswig's company Global Reserve BT, and the couple then used the money for their personal use.

One East County woman, who is 76, said Friday she lost $63,000 to the alleged investment scam. It was nearly everything she had saved, after a lifetime of setting aside $25, maybe $50, a month. Now, she said, she is reduced to living on her Social Security check, which is less than $1,000 a month, to cover gas, food and rent. Money is so tight, she said, that she quit going to church most days of the week because gas is too expensive.

Financial or fiduciary elder abuse is a growing problem in our society. As fewer people save sufficiently for retirement, those looking for ways to catch up or get ahead may find themselves in the grasp of unscrupulous investment advisers who offer generous investment returns that "look to good to be true." It goes without saying that anyone investing in an investment product that is "new" or "different" than what is conventional or widely accepted should seek a second opinion. The same goes for the advisors that offer returns that far exceed what the current market is offering.

As for the Reiswigs, police are asking those who think they, or someone they know may have been victims to contact investigator Joseph Cargel in the district attorney's office in San Diego at (619) 531-4040.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Financial Elder Abuse

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Since a significant part of my law practice involves cases of abused and neglected seniors in nursing home, I get asked frequently if I can recommend a good nursing home, or at least point out the bad ones. That is, of course, impossible because of the sheer number of nursing homes in California and the simple fact that every nursing facility, even ones with generally good reputations, have the potential for neglectful care.

When I am asked to recommend a home I typically refer people to the Nursing Home Guide. A web resource published by the California Advocates for Nursing Home Reform (CANHR) that provides detailed information about every licensed nursing home in the State of California, including information about prior complaints, citations, ownership, and the services provided. At the site you will also find a nursing home evaluation checklist, which provides a list of things to think about when looking for a nursing facility.

In addition, CANHR also now has a Residential Care Facility Guide which provides information about all licensed residential facilities in the state. The information there is limited, simply because public information about those facilities is not as available.

I encourage you to look at CANHR’s site. It is simply an awesome resource for nursing home, assisted living, and residential care information.

Posted by Randall Walton | Permalink | Email This Post

Posted In: CANHR , Nursing Home Abuse and Neglect , Residential Care Facilities

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Last week President Bush signed into law the Safety of Seniors Act, a bill dedicated to preventing injuries of the elderly inside the home. According to the CDC, one in every three Americans over 65 will suffer a fall their home, and nearly a third of those will require medical treatment. In addition, 80% of elderly Americans who suffer a serious fall will suffer an additional fall within a year.

The bipartisan legislation seeks to develop educational strategies to increase the awareness of falls, support research to identify populations at risk for falling, and encourage projects that promote fall prevention. In California, health officials say they will make fall prevention a major priority starting this summer.

According to the CDC, almost $20 billion dollars is annually on medical costs related to elderly falls, most of which is paid for the Medicare and Medicaid. Because of the aging baby boomers, that figure is expected to rise to $43 billion by the year 2020.

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Posted In: Assisted Living Facilities , Falls , Nursing Home Abuse and Neglect , Residential Care Facilities

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This comic strip is from the LA Times. We've had this case. The angry caregiver who assaults the nursing home resident, usually over some frustration related to care. Not so funny when it really happens.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Elder Abuse , Nursing Home Abuse and Neglect

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A nursing home in Riverside County was hit with a $100,000 fine after the state deemed the death of an 87-year-old woman, who died of acute peritonitis in June 2006, was due to neglect. The home was also issued a AA citation from the California Department of Public Health, the most severe citation that can be given to a nursing home.

According to reports, The Springs at the Carlotta, a 59-bed nursing home in Palm Desert, the elderly resident had suffered from constipation for 24 days. The nursing facility allegedly knew the woman was suffering from constipation when she entered the facility only weeks before her death, but failed to monitor her condition or her treatment. When she began to vomit on June 22nd, she was sent to the hospital where tests confirmed that her colon had perforated due to the constipation. She developed severe peritonitis and died a week later.

It took more than a year for the Department of Public Health to complete its investigation, and the facility has appealed the fine.

These types of deaths occurring all the time in nursing facilities, and are rarely reported. I can only assume that an attentive family member sought to investigate what had happened, because most of the time a death like this is dismissed as just an old person who reached the end of her life, not the result of neglect or negligence by the nursing home staff. Good for the people who looked into this case, and kudos for the state for issuing the citation, even if a year is an appallingly long time to complete an investigation, but that's a topic for a different day.

Let's hope this family gets some justice for what was likely a very painful and suffering death.

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Posted In: Nursing Home Abuse and Neglect

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Studies show that almost 50% of California nursing homes do not meet federal standards in preventing pressure ulcers. The problems are so widespread that the treatment of these ulcers – also called bed sores - will no longer be covered by Medicare if the sore was acquired after admission into a nursing home.

Family members should be aware that a bed sore can develop in only a few hours if an area of the skin is subjected to enough pressure that cuts off blood flow to that area. The skin will initially appear red and will be painful, slowing appearing to have a purple color. This is the best time prevent the sore from advancing to something more serious.

Nursing home and assisted living residents are at high risk for developing pressure ulcers, and those residents that are bedridden, wheelchair bound, or those will limited mobility must be examined frequently for the development of bedsores. A small bedsore can quickly become a large sore if treatment is not promptly provided.

Studies show that the best way to prevent these sores is a multidisciplinary approach, where all departments of the nursing home are involved in the prevention and care of bedsores, including departments such as laundry and maintenance. If you are responsible for a resident of a nursing facility, insist that the staff check frequently for the early stages of pressure sores, particularly the areas of the lower back and coccyx, and on the heels.

For more information about bedsore prevention and treatment, visit the Mayo Clinics website on the topic here.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Nursing Home Abuse and Neglect

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People frequently ask for a recommendation to a "good" nursing or residential care facility. It's a question that is difficult to answer, other than to state that the style of the building or the cost of the care is rarely a good indicator of quality of care. I have sued nursing and residential facilities that look like the Ritz Carleton, and I know that smaller, "mom and pop" facilities are capable of providing excellent care.

The first step is to find a facility that suits your needs. In may be its location in relation to family or friends, or one that offers a specific service such as dementia care. Once you have narrowed it down to a few, visit the facilities and speak with the administrator or the admissions director, and ask for a tour. While on the tour introduce yourself to other residents and ask them about the facility, the things they like and don't like, and ask if you can speak with the privately. Frequently your first impression is the most accurate, so trust your instincts.

After the tour, return unannounced to the facilities you like best a few days after your tour, and visit at various times of the day so you can see the program it runs throughout the day. It's important that these visits are unannounced so you can see the "real" facility and not the one portrayed on the official tour (hopefully they are the same).

Once you’re close to deciding, go visit to the nearest office of the Department of Social Services, Community Care Licensing and take a look at the facilities’ public file. The file will contain the facilities most recent inspection report, and complaints of abuse or neglect made against the facility over the last two or three years. While you're there, you may want to ask to speak to an evaluator for advice or recommendations, or to see if the facility you are interested in has a good reputation.

After doing all of this, if you're satisfied with your findings, then you've probably chosen a facility that's right for you. There are never any guarantees of course, but by doing the foregoing, you will greatly increase the odds that you will find a facility that works for you.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Assisted Living Facilities , Residential Care Facilities

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Nursing homes around the country are now requiring prospective residents to agree to binding arbitration before admittance into a home. By signing an agreement to arbitrate, nursing home residents are forever giving up any rights to seek compensation in a court of law for harm caused by caregivers who abuse or neglect a resident, or for any other nursing home malpractice. Those claims would be handled by an arbitrator, usually a retired judge or an experienced (but often jaded) lawyer.

These arbitration clauses have profound implications, and should be avoided when possible. As this Wall Street Journal article points out, they are a part of a nursing-home-industry strategy to use arbitration agreements to reduce litigation costs, take cases away from juries, and lower compensation awards.

Apparently it has worked. According to a nursing home industry study, average costs to settle cases have begun decreasing as claims of poor treatment are increasing. Nursing homes have learned over the years that neglect or abuse of a vulnerable senior citizen is an emotionally charged thing. And when juries get emotionally charged, they tend to take action to right the wrong that has been committed - usually in the form of verdict commensurate with the wrongdoing - exactly as the U.S. Constitution intended.

Sadly, this is becoming standard practice. In our law practice we frequently get cases of profound injury or death, and discover shortly after taking the case that a jury will never get to hear the terrible story because the victim agreed to arbitrate upon admission; an agreement often entered into months or years before the neglect.

The answer to this problem? Don't sign the arbitration agreement. In California, an agreement to arbitrate must be a separate document from the admission contract itself, and a refusal to sign cannot be the basis for a refusal to admit a resident. The best way to avoid the harsh restrictions of arbitration is to avoid it at the beginning. Another way is to support a nursing home bill introduced last week by two U.S. Senators that would ban the use of arbitration agreements in nursing home contracts. Contact the offices of Senators Boxer and Feinstein and urge them to support this bill.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Arbitration Agreements

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