• Suspect nursing home abuse or neglect?
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handsIf California nursing home employees go on strike, who will provide care for patients residing in the facilities? Should families of those patients have concerns about nursing home neglect? According to an article in the Marin Independent Journal, sixty nursing home workers went on strike last month in San Rafael following a string of nursing facility violations from government regulators. The strike was aimed at forcing the nursing facility to cease its understaffing practices and to encourage a work environment in which providing a threshold level of care for patients is among the most important logistics of running the facility. Even if such a strike is intended to improve conditions, who cares for patients while employees are on strike?

Understaffing and High Turnover Limits Quality of Care

The recent strike occurred at San Rafael Healthcare and Wellness Center, which is owned by Brius Healthcare Services. With more than 80 facilities in California, Brius is the largest nursing home chain in our state. For the last 18 months, employees of the nursing home have been working without having a contract. Why are employees working without a contract? About a year and a half ago, those workers rejected the terms of a union-negotiated contracted because it did not do enough to deal with the serious understaffing problem at the facility.

According to Maria Martinez, a Certified Nursing Assistant, patients at the nursing home suffer because of its nearly constant problems with understaffing. Why is the facility routinely understaffed? One of the underlying issues, Martinez suggests, is the low wage paid by the facility. Without a promise of a sufficient wage, employees are unlikely to remain at the nursing home for an extended length of time. Between 2012 and 2014, the turnover rate was 50 percent.

As a result of the understaffing, nurses and assistants cannot provide patients with the kind of care many of them require. Olga Espinoza, one nursing assistant at the facility who has remained in her position for the last five years, explained that “one nursing assistant ends up taking care of 13 patients at a time.” That is not a sufficient ratio of patient to nursing staff if we want to ensure that nursing home residents receive proper care. As Espinoza emphasized, “it’s not fair to the patients.” Another nursing assistant divulged even more concerning numbers. Often during the night shift (between 11 p.m. and 7 a.m.), the facility has only one employee working and 46 patients in need of care.

Determining the Effectiveness of a Strike

When the San Rafael nursing home employees went on strike, the nursing home pulled employees from nearby Brius facilities to ensure that patients would not suffer from neglect. But if other Brius facilities are as understaffed as San Rafael Healthcare, the idea of removing employees does not necessarily sound like a good thing.

The spokesperson for Brius did not comment on the total number of staff members caring for patients at San Rafael Healthcare and other Brius facilities. Instead, the spokesperson emphasized “maintaining our high nurse-to-patient ratio is important to us.” The Brius spokesperson has not indicated how the nursing home chain plans to deal with its poor turnover rates and complaints about inadequate nurse-to-patient ratios.

In the meantime, if you have questions about a loved one’s safety in a California nursing home, do not hesitate to reach out to a San Diego nursing home neglect lawyer to discuss your case. Contact the Walton Law Firm today to find out more about how we can assist you.

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Interdisciplinary Approach to Elder Abuse Prevention

Modernizing Nursing Home Safety

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file000356994816When older adults continue to live at home with help from a caregiver, elder neglect can become a serious issue. Although some caregivers have medical training and should be expected to care for the elderly in a manner that emphasizes safety, some caregivers are not properly trained and can be implicated in situations of elder abuse and neglect. These situations can become even worse when an older adult needs medical treatment and cannot rely on a caregiver for transport to a hospital or a physician’s office. That is where a new transportation service for the elderly comes in, according to a recent article from the California Health Report.

Mobility is a Significant Issue for the Elderly

Mobility is a significant issue for elderly California residents. Whether an older adult needs transportation to a medical appointment or simply to the grocery store to buy food, a new service can help. Recognizing that elderly Californians often have difficulty getting where they need to—or would like to—go, Eric Wong developed Lift Hero. Lift Hero t is a service that looks a lot like Uber or Lyft, but it is designed specifically for seniors who do not have other modes of transportation.

Wong earned a Master’s degree in gerontology from Columbia University, and afterward decided to work with Lift Hero in order to provide a much-needed service to members of the community who have few options. The company was founded last fall by Jay Connolly with the aim of improving seniors’ health. As the article explains, “isolated seniors are often at the mercy of absurdly inefficient bus routes or impoverished dial-a-ride programs.” When older Californians do not have the option to leave their homes, physical effects may begin to show. “Isolation and despair can lead to dire health conditions like depression, high blood pressure, and alcoholism.”

Sometimes depression and other psychological conditions can result in self-neglect. While we usually hear more about neglect in relation to a caregiver or staff member at a nursing home or assisted-living facility, seniors can also suffer injuries through self-neglect.

Learning More About Self-Neglect

The National Center on Elder Abuse (NCEA) and the Administration on Aging (AoA) emphasize that elder abuse and neglect can take many forms. One of those is known as self-neglect. According to a fact sheet from the NCEA and the AoA, self-neglect is usually “characterized as the behavior of an elderly person that threatens his/her own health or safety.” It is not characterized by a mentally incompetent older adult, but rather by someone who “makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice.” Signs and symptoms of self-neglect can vary, but they can include some the following:

  • Malnutrition;
  • Dehydration;
  • Medical conditions that have not been properly attended to;
  • Poor hygiene;
  • Unsafe living conditions;
  • Unsanitary living conditions; and
  • Lack of necessary clothing, shelter, or medical aids.

Whether an older Californian is at risk of elder neglect or self-neglect, services like Lift Hero may be able to help with one serious issue – mobility. If you have questions or concerns about elder abuse or neglect, you should always speak with an experienced San Diego elder abuse attorney about your situation. Contact the Walton Law Firm today to discuss your case.

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Modernizing Nursing Home Safety

Difficult Decisions for Families as Nursing Home Costs Rise

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Could helping more of America’s seniors to live independently be a method for preventing nursing home abuse? If an elderly San Diego resident does not require the kind of care that an assisted-living facility or a residential care facility for the elderly (RCFE) would provide—if she can have that same kind of care at home—would she take away some of the risks of becoming a victim of elder abuse? One of our first steps in preventing elder abuse should be to make care facilities safer for older adults. But at the same time, even if we did want to push for more seniors to live independently, a recent article in Forbes Magazine suggests that our country simply is not providing the kind of assistance that would make this possible.7622108790_a2a735a94a

Older Americans Act (OAA) and Providing Assistance to Seniors

Every year, elder rights advocates and others attend the National Home and Community Based Services Conferences, which brings together professionals in various fields to discuss the state of independent living for older adults and those with disabilities. The conference is sponsored by the National Association of States United for Aging and Disability, and it has more than 1,400 participants. Indeed, Kathy Greenlee, the Assistant Secretary for Aging, gave an opening speech that marked the 50th anniversary of the Older Americans Act (OAA).

As Greenlee pointed out, the OAA and other laws aimed at assisting older adults have good intentions. At the same time, much work remains to be done. If we truly want older adults who are able to have the option of independent living, we need to do more. Greenlee articulated in her speech that, “as advocates, we specialize in being frustrated with these programs.” As she explained, “we know we need more funding for OAA, we know there are gaps in Medicare . . . and we know we need to do more balancing these frustrations.” Yet at the same time, Greenlee emphasized that the very existence of these programs at all points to a nationwide investment in older adults.

If we were to provide more through programs funded by the OAA, such as Meals on Wheels, would more of California’s seniors feel safe in their living environments?

Generating Funding to Prevent Elder Abuse

Helping more seniors to live at home as they age could provide those older adults with the sense that they are empowered to report situations of elder abuse or neglect. Yet elder abuse does not just happen in nursing homes. While the term “nursing home abuse” does refer to violence that takes place in a particular kind of facility, it implicates numerous forms of abuse that take place in nursing facilities, but also within the care of home health aides, visiting nurses, and even family members. To be sure, elder abuse is not relegated to a specific kind of space, and it can happen when a senior lives at home, too.

Why are so many elder safety advocates focusing on the reauthorization of the OAA? Should we not, instead, be focused on preventing elder abuse at home and within care facilities? The OAA and outreach efforts discussed at the conference do not deal solely with independent living practicalities. Indeed, the conference also focused, for instance, on generating more funding to raise awareness about the risks of elder abuse in dementia patients, and the need for “doctors to work with law enforcement to help them investigate charges of elder abuse where the victim may have significant memory loss.”

In short, advocates in many areas are working together to consider more ways to make aging healthier and to help prevent elder abuse among the aging population. If you are worried about an elderly loved one who is receiving care in a nursing home or an assisted-living facility, you should reach out to an experienced San Diego nursing home abuse lawyer as soon as possible. Contact the Walton Law Firm today to find out more about how we can help.

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Decisionmaking in Nursing Homes for Incompetent Residents

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What does required care for a nursing home patient with burn injuries look like? Patients who suffer from substantial burn injuries and are residing in nursing homes in Southern California must receive a certain level of care in order to be safe from additional injuries. However, according to a recent article from the Los Angeles Daily News, a Montrose skilled nursing home and two of its staff have been charged in relation to the death of a burn patient. According to the newspaper, the charges indicate that the facility and staff members failed “to provide required care to a resident who was a burn victim.” When does negligence rise to the level or nursing home abuse or neglect?2222910959_90b0c86fa5

Nursing Home Neglect

The nursing home, Verdugo Valley Skilled Nursing and Wellness Center LLC, is alleged to have been “grossly negligent” in its care of a burn victim who previously resided at the facility. The patient had burns on 90 percent of his body, injuries that resulted from an arson fire that occurred about 20 years ago. According to the complaint, which was filed by Attorney General Kamala D. Harris, the nursing home did not provide proper care to the patient, and because of its negligence, the patient died.

The Attorney General explained her reasoning for filing the complaint: “Families who entrust loved ones to the care of a nursing home rightfully expect residents will receive the care and attention they need and that nursing homes have a legal duty to provide.” However, Harris’s complaint alleges that “Verdugo Valley and its employees violated that trust and their legal duties in a way that resulted in a senseless, tragic, and unnecessary death.”

The patient resided at Verdugo Valley for 14 months. During that time, the Attorney General’s office indicated that the patient was linked to 80 change of condition forms, but none of them had a treating physician’s signature, which was required. The patient is alleged to have suffered from “severe weight loss, sepsis, and pneumonia.” He died on August 30, 2014 of “multiple system failure due to sepsis,” at which time the patient had “infections throughout his body.”

Alleged Gross Negligence in Patient’s Death

The two staff members charged in the death include the director of nursing at Verdugo Valley, as well as the supervising nurse. In addition to the serious issues noted above, the charges also allege that the staff members:

  •      Failed to call 911 in a timely manner;
  •      Failed to properly document changes in the patient’s condition; and
  •      Made false entries in the patient’s medical records.

What is gross negligence, and how does it different from a more common negligence or neglect allegation? According to regulations posted by the California Department of Consumer Affairs and Board of Registered Nursing, gross negligence is defined as

“an extreme departure from the standard of care which, under similar circumstances, would have ordinarily been exercised.”

What is an extreme departure from the ordinary standard of care? The definition goes on to explain that an extreme departure “means the repeated failure to provide nursing care as required or failure to provide care or to exercise ordinary precaution in a single situation which the nurse knew, or should have known, could have jeopardized the client’s health or life.”

Nursing home neglect occurs much too often, and it is preventable. If you have concerns about a loved one’s safety in a nursing home or assisted-living facility, it is never too early to discuss those concerns with an experienced San Diego nursing home abuse attorney. We are here to help. Contact the Walton Law Firm today to learn more.

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Elder advocates and those who work tirelessly to prevent nursing home abuse can be involved in many different professions, including medicine. According to a recent news release from USC News, geriatrician Laura Mosqueda is a “leader in the study and prevention of elder abuse,” and she’s continuing to work toward the prevention and early detection of elder neglect in California. Mosqueda is currently the director of the National Center on Elder Abuse (NCEA), and she hopes that her work in Southern California will have lasting impact on older throughout the region.6240576176_62b88ae159

Interdisciplinary Work to Prevent Elder Abuse and Neglect

One of Mosqueda’s focuses in the prevention and detection of elder abuse and neglect is taking an interdisciplinary approach to the problem. Sometimes we think of elder abuse prevention as a job that falls within the realm of community advocates or healthcare professionals who have daily contact with older adults. And sometimes we note that dedicated San Diego nursing home abuse attorneys play an important role in holding abusers accountable. But Mosqueda has worked to bring together elder advocates in multiple fields and professions on behalf of the elderly community.

When she worked and taught at the University of California, Irvine, Mosqueda co-founded an Elder Abuse Forensics Center—the first of its kind in the country. The Center became a “hub for legal, medical, law enforcement, and social services strategies to improve the investigation and prosecution of elder abuse cases.” The Center has been so successful that it became the model for the Los Angeles County Elder Abuse Forensic Center, with ties to the University of Southern California.

Since beginning her work at USC, Mosqueda has continued to serve as director of the NCEA, which comes with it a 3-year, $2.2 million grant from the Administration on Aging. And she has also begun reaching out to faculty members across departments at USC in order to continue “building interdisciplinary bridges around the study of elder abuse.” For instance, Mosqueda has begun working with colleagues in law, business, education, and social work (in conjunction with her own work in the USC Davis School of Gerontology).

Elder Abuse as an Important Issue in the Medical Community

While Mosqueda cites the importance of interdisciplinary work to put an end to elder abuse in California and throughout the county, she emphasizes that elder abuse is a significant issue in the medical community of which healthcare providers need to take note. As she explains, “the vast majority of Adult Protective Services workers have little or no medical training,” and this becomes a problem since they “are not lifting up shirts and looking for wounds.”

To be sure, bruising is a common sign of nursing home abuse, but some APS employees work under the misconception that aging adults simply bruise more easily than younger people. While Mosqueda indicates that older adults do bruise more easily, “you shouldn’t see bruising on the face, the head, the neck, the soles of the feet, the torso,” and “you shouldn’t see multiple bruises and large bruises without a reasonable and believable explanation.”

By bringing together advocates in multiple fields, elder abuse awareness and prevention measures can obtain more funding and can tackle the problem from multiple angles.

If you have concerns about a loved one’s safety in a nursing home or an assisted-living facility, you should discuss your case with an experienced San Diego elder abuse lawyer as soon as possible.

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Arbitration Agreements in Nursing Homes

California’s Senior Legislature Wants to Continue its Advocacy Work

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According to a recent article from Kaiser Health News and NPR, proposed federal rules are aiming at “modernizing” nursing home safety requirements across the country. What does modernization mean in this context? Given that the proposal contains “hundreds of pages of proposed changes,” which “cover everything from meal times to use of antipsychotic drugs to staffing,” it looks like modernization would require quite a bit of effort. In all likelihood, such modernization is deeply needed to help prevent nursing home neglect at facilities in California and throughout the nation.


Better Technology Requires Revision to the Rules

If approved the proposed rules will require nursing homes comply in order to qualify for payments from Medicare and Medicaid. Medicare officials also think it’s time for a change. According to Dr. Shari Ling, the deputy chief medical officer for Medicare, “the existing regulations don’t even conceive of electronic communications the way they exist today.”

In addition, as Ling explains, the rules need to be revised since “there have been significant advances in the science and delivery of health care that just weren’t imagined at the time the rules were originally written.” For instance, Ling points out, “the risks of antipsychotic medications and overuse of antibiotics are now clearly known, when previously they were thought to be harmless.” Given such shifts in technology and knowledge, the proposed regulations have a specific section about how electronic health records should be managed.

Making Nursing Homes a Safer Place to Live

What else, specifically, will nursing homes need to do in order to prevent patient injuries and to help make these facilities safer and healthier places to live? While we can’t detail the information in the hundreds of pages that make up the proposed revisions to the rules, we can provide you with some of the highlights, including but not limited to the following:

  • Strengthening infection control;
  • Minimizing antibiotics and antipsychotic drugs;
  • Promoting individualized care to “help make nursing homes feel more like home” by allowing residents to have snacks and meals at “non-traditional times or outside scheduled meal times”;
  • Allowing nursing home residents to choose their roommates;
  • Training nurses in dementia care;
  • Training nurses in elder abuse prevention; and
  • Reporting of staffing levels, which will be reviewed by Medicare officials.

Commentators suggest that elder advocates won’t be pleased that the proposed changes don’t address a specific nurse-to-resident ratio, and that revisions to the rules won’t involve specifics on enforcement.

However, requiring additional training for nurses can go a long way in helping to reduce the number of injuries caused by nursing home abuse and neglect. While deepening the skill sets of staff members won’t necessarily change the number of nurses at each facility, officials believe that better training can help “to provide the nursing care a resident needs rather than a static number of staff hours of nursing care that does not consider resident characteristics.”

And changes such as those allowing residents to choose the person or persons with whom they’ll room can have a big impact on someone’s daily well-being. As the proposed rules explain, given that nursing facilities aren’t just medical-care centers but also homes, it’s important for residents to feel the same way. The roommate provision “would provide for a rooming arrangement that could include a same-sex couple, siblings, other relatives, long term friends, or any other combination.”

Officials are hopeful that changes to the rules will make enforcement easier by making violations clearer to investigators. In the meantime, if you have concerns about nursing home abuse or neglect in a Southern California facility, you should contact an experienced San Diego nursing home abuse lawyer as soon as possible.

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According to a recent article from Kaiser Health News, until recently, a California law permitted nursing homes to make decisions—include about end-of-life care—for nursing home residents who have been declared incompetent. However, a state court recently held that the law, which was enacted more than twenty years ago, is unconstitutional.7750519890_1720d30f09

Nursing Homes Cannot Violate Patients’ Rights

The law remained in effect until Alameda County Superior Court Judge Evelio M. Grillo ruled that the law is unconstitutional in a decision that came down at the end of last month. As the judge explained, “the law violates patients’ due process rights because it doesn’t require nursing homes to notify patients they have been deemed incapacitated or to give them the chance to object.” While Grillo indicated that he knows the decision “is likely to cause problems” for regular nursing home operations, it’s more important to put nursing home patients’ rights above practical logistics.

Initially, legislators saw the law as a tool to allow nursing facilities to “give medical treatment to their incapacitated residents without having to wait up to six months for state approval.” Yet elder rights advocates have been pushing to move away from the tenets of that law for quite some time. To be sure, the California Advocates for Nursing Home Reform (CANHR) filed a lawsuit against the California Department of Public Health in 2013 alleging that “nursing homes used the law to administer anti-psychotic drugs, place residents in physical restraints, and deny patients life-sustaining treatment.” In other words, advocates have voiced serious concerns about whether the law is being used as it was intended.

Patients need to have input in end-of-life decisions, in particular, Judge Grillo’s ruling emphasized. In making his decision, the judge cited a 2013 case in which a nursing home resident who had been deemed mentally incapacitated was taken off life-sustaining treatment without his input. He died shortly thereafter.

Acknowledging Rights, Regardless of Capacity

Citing the recently overturned law, backers of the CANHR underscored that, with Grillo’s ruling, “residents are finally going to have their rights acknowledged and honored.” Indeed, as one CANHR advocate clarified, “what nursing homes used to do was routinely make decisions big and small for their residents without really any regard to due process.” The Alameda decision will hopefully change that. And advocates hope that Grillo’s ruling will also make nursing home residents without representatives more of a priority for the California Department of Public Health.

The ruling may pose difficulties in certain nursing home situations, however. As one commentator pointed out, we need to think about scenarios in which nursing home residents lack mental capacity but don’t have representatives, and they object to certain treatment. How are facilities supposed to handle such a situation? And while allowing patients who lack capacity to object to antipsychotic medication may be useful in facilities alleged to be overmedicating, what if a patient who “truly needs” an antipsychotic drug objects to taking it? Such a scenario could pose safety issues to staff and other residents.

While Judge Grillo did note the possibility of certain difficulties in nursing homes given his recent ruling, he nonetheless emphasized that “informing patients and allowing them to object is not likely to result in any significant burdens on nursing homes.”

Contact a San Diego Elder Abuse Lawyer

Nursing home abuse and neglect are serious problems at California nursing homes and assisted-living facilities. In many cases, signs of neglect aren’t always strikingly obvious. If you have concerns about whether your elderly loved one’s rights have been violated in a nursing home, it’s important to discuss your case with an experienced San Diego nursing home abuse attorney. Contact the Walton Law Firm today to learn more about our services.

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A common blood-thinning drug, Coumadin, has been cited as the cause for numerous deaths in nursing homes, according to a recent article in the Washington Post. What’s the problem with Coumadin? In short, it requires that a very precise amount be administered to patients, and either too much or too little of the medication can result in fatal injuries to the elderly.12175858204_36c6287934

What is Coumadin?

According to WebMD, Coumadin is the brand name for the generic drug Warfarin. It’s generally used to treat blood clots, or to prevent clots from forming (and thus to help reduce a patient’s risk of a stroke or a heart attack). This medication often is described as a blood thinner, but as WebMD explains, “the more correct term is anticoagulant.” Coumadin, when used properly, can decrease the clotting proteins in your blood, which ultimately can help blood to flow better if there’s a risk of clotting.

But this medication comes with very serious risks. As the Washington Post article articulates, failing to maintain a “delicate balance” of Coumadin can lead to death. Indeed, “the drug must be carefully calibrated: too much, and you can bleed uncontrollably; too little, and you can develop life-threatening clots.”

Nursing Home Fatalities Caused by Coumadin

Between 2011 and 2014, “at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin.” During that period, 18 residents in California nursing homes suffered fatal injuries from the drug. And studies suggest that thousands of injuries each year likely occur as a result of using Coumadin, but those injuries aren’t investigated. As such, they don’t show up in the data reported.

According to Rod Baird, the president of Geriatric Practice Management, Coumadin is “an insidious problem.” To be sure, Baird described it as “the most dangerous drug in America.” While nursing homes have been under scrutiny for the overuse of antipsychotic medications—particularly among patients who suffer from dementia—these facilities haven’t seen much scrutiny over the ways in which Coumadin is administered and patients are monitored. Although Coumadin can benefit nursing home patients, it has also resulted in serious and fatal injuries.

For instance, and 85-year-old nursing home patient on Coumadin was discovered with bruises covering his body and blood oozing from his gums. That patient had been taking Coumadin because of abnormal heart rhythm, but the drug wasn’t calibrated properly for him and led to severe bleeding. An 89-year-old grandmother in San Diego, Dolores Huss, also recently suffered internal bleeding from the drug. Her injuries proved fatal. Huss received an antibiotic that “multiplied the effects of Coumadin,” and she didn’t have additional blood tests done to determine the rate at which her blood was clotting.

Nearly eight years ago, a study in the American Journal of Medicine suggested that “nursing home residents suffer 34,000 fatal, life-threatening, or serious events related to the drug each year,” and Coumadin often accounts for more medical errors in nursing homes than other drugs. Yet the problems with this drug aren’t obvious to those who haven’t been affected, since officials aren’t making clear the risks that come with taking Coumadin. Although many of the facilities in which patients have been harmed by the medication have received fines, thousands of seniors continue to take Coumadin, and they may not be receiving the kind of monitoring that is necessary to prevent severe or deadly injuries.

If your elderly loved one recently suffered injuries after taking Coumadin, you should discuss your case with an experienced San Diego nursing home abuse attorney. Contact the Walton Law Firm today to learn more about how we can assist you.

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When the costs of nursing home care are too high to provide families with seemingly decent options, do the risks of nursing home abuse and neglect become more prominent? According to a recent article from The Associated Press, elderly Americans are realizing that, if they require care in a nursing home, they’ll quickly outlive the amount of money they’ve managed to save. Indeed, “for the two-thirds of Americans over 65 who are expected to need some long-term care, the costs are increasingly beyond reach.” But will lower-cost options result in a lower quality of care?5846273434_ffcbff26a6

Unreachable Costs of Care

How much does it cost to receive long-term care? According to the article, “the median bill for a private room in a U.S. nursing home now runs $91,000 a year,” and “one year of visits from home-health aides runs $45,760.” Those numbers are even higher in California.

Based on data collected by Genworth Financial, the annual cost of a home health aide in our state is $52,624, while the annual cost of a private room in a nursing home is $104,025. While the cost of home health care isn’t expected to rise drastically in the coming years, Genworth does predict a 5-year annual growth of 4 percent when it comes to nursing home care in the state. And when we look at the numbers for San Diego in particular, we see even higher costs of nursing home care. For a private room in San Diego, the current annual cost of nursing home care is $127,750, and Genworth predicts a 5-year annual growth of 7 percent.

Even when seniors get a Social Security check each month, they’re still in need of thousands of dollars to cover the remaining cost of care in the average facility. Does the gap between ability to pay and cost of care result in elderly Americans seeking out options that cost less but provide a lower quality of care?

Bridging the Gap Between Income and Cost

For middle-class Americans between 55-64, the median balance in retirement accounts is $104,000. When you take into account that Medicare won’t cover long-term stays in nursing homes, you have to figure that most seniors who are firmly in the middle class and require this level of care will end up paying hundreds of thousands of dollars out of pocket. To be sure, they’re unlikely to qualify for Medicaid based on income and savings. However, their retirement accounts probably don’t have enough to cover the cost of a multi-year stay in a nursing home.

Some people save money by switching to shared rooms, which run, on average, “$11,000 a year less than a private room.” But when people can’t pay their bills at nursing homes, they can be evicted. Indeed, the article tells the story of a resident whose added dementia care and frequent trips to the emergency room—costs that weren’t covered by Medicaid—resulted in a 30-day notice to “find a new home.” When this happens, seniors can receive inadequate care, and they can sustain serious and even fatal injuries.

No matter what kind of care your elderly loved one receives, it’s important to know that older adults have rights. Regardless of the cost of a facility or of home care, elderly Californians should not become victims of elder abuse or neglect. If you are worried about the health or safety of your parent or loved one, contact an experienced San Diego nursing home neglect attorney today to find out more about how we can help.

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The Centers for Medicare & Medicaid Services (CMS) recently proposed a rule forbidding nursing homes from “requiring residents to sign binding arbitration agreements,” and according to a recent article in Modern Healthcare, the rule is “long overdue.” While California currently requires nursing homes to use only voluntary arbitration agreements—something that the American Health Care Association has been seeking—even voluntary agreements can pose problems for nursing home residents in the event of an elder abuse claim.6337308344_52480361a7

Are Voluntary Agreements Always Voluntary?

To have a better understanding of why even voluntary arbitration agreements might not be so great, it’s important to recognize why nursing homes and other facilities use them in the first place. In short, they “help nursing homes avoid costly litigation.” In other words, if a patient (or her family) thinks about filing a nursing home neglect lawsuit, an arbitration agreement can prevent her from doing so. Instead, she’ll have to go through arbitration. And many arbitration agreements—even voluntary ones—appear amidst a lot of other paperwork that appears when a patient enters a nursing home.

It’s clear that mandatory arbitration agreements are detrimental to patients. But given that California already requires voluntary agreements, do those ultimately end up working any differently? According to one California elder law advocate, “every one of us could tell you horror stories about these arbitration agreements because they’re used for the wrong reasons all the time.” To be sure, the proposed rule “might not solve the issue of residents feeling as if they have no choice but to sign even voluntary agreements.”

The proposed rule does include language about requiring facilities to ensure that, when residents sign a voluntary arbitration agreement, they know what they’re signing. In particular, the drafters of the rule are concerned about the unequal bargaining power between nursing homes and residents who need care. To contend with that possibility, the rule instructs facilities to explain the language in an arbitration agreement “to the resident in a form, manner, and language that he or she understands, and have the resident acknowledge that he or she understands the agreement.”

Looking Out for the Patient’s Side of the Story

But even if a nursing home must explain an arbitration agreement in plain language to a resident, can we really trust that the resident truly understands what she’s signing? According to Stephen Ware, a law professor at the University of Kansas, “you can imagine the nursing home’s witness giving his or her side of that story, and you can imagine the resident or resident’s child giving his or her side of that conversation.”

Ware also has concerns about “who might be assigned to explain the agreements to residents.” Indeed, “detailed training would be needed” to ensure that elderly patients have a grasp on the language they’re hearing. The University of Kansas professor suggests that a uniform document that explains voluntary arbitration agreements could be particularly useful.

And in California, advocates contend that voluntary arbitration agreements simply look like they’re “part of the admissions packet” to a nursing home. In other words, even if patients aren’t absolutely required to sign, it looks like they’re required based on how the paperwork is presented.

If you are concerned about a loved one’s safety in a Southern California nursing home, it’s important to connect with a San Diego nursing home abuse lawyer about your case. Contact the Walton Law Firm today.

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