Nursing Home Abuse and Neglect Blog

Residential care facilities for the elderly (RCFE), or assisted living facilities, are typically board and care homes for individuals age 60 or older who can no longer live by themselves, but do not need 24-hour nursing care. Typically, a RCFE will provide a bed, all meals, and assistance with certain daily activities such as bathing, dressing, meals, and with medication distribution. The residents, however, must be able to take their own medications.

RCFEs and assisted living facilities are licensed by the State of California, and are limited under the code of regulations to the type of care they can provide. In addition, each facility must undergo periodic inspections by the Department of Social Services.

It is important to point out that RCFEs are not permitted to provide medical care. As a result, individuals with certain medical conditions may not be admitted or retained by a residential care facility. A few of those conditions include, but are not limited to, bed sores of a Stage III or larger, or people who require tube feedings. Other conditions are restricted and may not be permitted, such as individuals who require catheters or colostomies. RCFEs may admit people who suffer from dementia, but only after meeting certain regulatory requirements. Always check for the facility’s written plan for caring for individuals with memory impairment.

If you have a loved one in a RCFE or assisted living facility, keep a watchful eye for deteriorating health conditions. Walton Barber LLP has handled several cases under which the RCFE resident suffered declining health with being noticed by the daily caregivers. These facilities must know when it is time for an aging resident to be transferred to a higher level of care such as a hospital or a skilled nursing facility.

Walton Barber LLP is a consumer law firm that represents individuals throughout Southern California in all types of injury and accident cases, including wrongful death and nursing home abuse and neglect.

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Posted In: Assisted Living Facilities , Residential Care Facilities

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Registered sex offenders, parolees, and individuals with violent pasts are living in nursing homes and assisted living facilities all over America according to the advocacy organization A Perfect Cause, which found 1,600 registered sex offenders in U.S. nursing facilities with senior citizens.

Wes Bledsoe, founder of the organizations, says that the group has documented over 60 rapes, murders, and assaults committed by criminal offenders inside these facilities. There is currently no federal or state law that keeps sexual offenders out of long term care facilities, and, in fact, many are sent to facilities by local judges, sheriffs, and county workers. Bledsoe is testifying before congress this week on the subject, and will call for the establishment of separate and secure nursing facilities for known sexual offenders, as well as a requirement of criminal background checks on all incoming residents.

"I hope that some of the congressional leaders don't sleep soundly tomorrow," said Bledsoe, "and that this makes an impression on them that right now, in this moment, we have people in harm's way."

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Posted In: Nursing Home Abuse and Neglect , Peer Abuse

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Walton Barber attorney Randy Walton was a guest presenter last weekend at the annual meeting of the California Association of Long Term Care Medicine in Los Angeles. Walton and San Diego attorney Bill Wilson spoke to a group of approximately 150 physicians, nurses, and administrators about legal liability in the long-term care setting. The title of the presentation was Long-Term Care Liability Crisis: Risk Management Update and Mock Trial.

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Posted In: Nursing Home Abuse and Neglect

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Elder abuse comes in a variety of forms. The abuse we hear about most frequently is physical abuse, which includes assault, battery, and sexual offenses, and financial abuse, which is usually a matter of fraud or undue influence upon a senior citizen. Both physical and financial abuse are very serous offenses that should be promptly reported to the police, and a private civil attorney.

Another, less discussed, form of abuse is abuse in the nursing home or assisted living setting. In California, there are approximately 100,000 nursing home beds, and probably an equal number of assisted living beds, and the health and well being inside these facilities usually depends on the quality of the care they are receiving. In truth, the word “abuse” is probably a bit misleading, as these occurrences are usually a matter of neglect of the elderly resident, not physical abuse.

Unfortunately, most instances of neglect or abuse are not reported. Elderly residents are often afraid to report an act of abuse or neglect for fear of retribution by staff, or simply because they cannot stand the thought of being transferred to a different facility. Or, more often, the decline in health caused by the neglect is attributed to some other cause, usually related to old age.

I typically tell people that if there is any unexpected injury, illness, or death, then it’s important to take a look at the records to determine the actual cause. Yes, people of advanced age usually have a variety of health problems, and most of the time illness or death is a naturally occurring event, and not the result of neglect or abuse. But if you, as the loved one, have a sense that something is not right, then I would suggest that an attorney with experience in nursing home abuse or neglect cases take a look at the person’s medical file.

The law firm of Walton Barber LLP represents seniors and dependent adults who are victims of neglect, abuse, mistreatment, and malpractice in the nursing home, assisted living, and residential care setting. Cases in all Southern California counties are accepted, including San Diego, Los Angeles, Orange, Riverside, San Bernardino, Ventura, and Imperial.

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Posted In: Assisted Living Facilities , Elder Abuse , Nursing Home Abuse and Neglect , Orange County Nursing Home , Residential Care Facilities , Riverside Nursing Home , San Bernardino Nursing Home , San Diego Elder Abuse , San Diego Nursing Home

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I recently attended a nursing conference where the central theme was elder abuse and neglect. One of the presenters was Charlene Harrington, Ph.D. of UCSF, a professor of nursing and sociology, who is considered an expert on nursing home staffing.

According to Harrington the nursing home staffing picture in California isn’t pretty. She said that there are over 12 million deficiencies in U.S. nursing homes annually, and stated that approximately one-quarter to one-third of all nursing homes provide substandard care.

According to Harrington, sufficient staffing is the number one indicator of the quality of care one can expect to receive in a nursing home. California requires that a licensed skill nursing facility provide at a minimum of 3.2 hours of nursing, per patient, per day. While this is a minimum standard, most California facilities view it as the threshold, striving only to meet it. In fact, RN care has been declining in California, which now has one of the lowest RN per patient, per day ratios in the country.

Harrington says those that view California’s 3.2 hours as more a ceiling than a floor are operating on dangerous footing, emphasizing that 3.2 hours is a minimum requirement. Adequate care for most facilities, she says, requires much more nursing, and believes the law should be changed to require 4.1 hours per patient, per day.

Ultimately, those facilities that provide more licensed nursing per patient, per day, tend to have fewer problems and a more satisfied patient population.

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Posted In: Nursing Home Abuse and Neglect , Staffing

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According to estimates, there are about 1.6 million people in the United States employed to provide home care for the elderly, and advocates for the elderly say the cases of abuse, neglect, and fraud by home caregivers is growing at an alarming rate. The increase is prompting calls for more government oversight as home-care assistance grows along side the aging baby boomers, and the desire of people to avoid nursing homes.

Because the bulk of home care is being provided by non-licensed or certified nurses, who are typically regulated under state, home caregiver frequently have no training, receive minimal pay, and loosely supervised. In California, home aides who do not provide medical care are not even required to pass a criminal background check.

To research the problem, the Centers for Medicare and Medicaid funded a study that screened 214,167 people who held jobs provided assistance to the elderly and discovered that over 5,000 of them had criminal histories. Advocates for the elderly are advising consumers to verify background checks from any agency that offers home care services, and those who hire directly are strongly encouraged to check references.

Walton Barber LLP represents victims of nursing home neglect throughout Southern California, including the counties of Los Angeles, Orange, San Diego, Riverside and San Bernardino.

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Posted In: Home Health Care

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About four years ago I had a very interesting case involving the death of a developmentally disabled adult in a San Bernardino care facility. In my case, the thirty-year old severely disabled man was found barely breathing on the floor next to his bed just after midnight. Medics were called, and tried to sustain his life, but sadly the man died. Staff and the family presumed it was a heart attack, since the decedent was very obese and had a history of some heart problems.

An autopsy, however, showed a different case of death. The medical examiner ruled the death a homicide, finding that the man died from blunt force trauma to his abdomen. The next question for use was Who did it?

Through the discovery process in a lawsuit we filed against the facility, we believed the death was caused by either a disgruntled employee, who was tired and angry at the resident for the demands he made on staff time, or an autistic room mate (who could not speak), who accidentally kicked the decedent in an act of self-defense. The case settled before trial, so those questions were never fully answered.

Today, the Government Accountability Office issued a report that states should more thoroughly investigate the deaths of developmentally disabled people who are receiving community based care. The GAO found that the manner in which deaths were investigated varied widely from state to state, and many investigations were inadequate to determine if the deaths were the result of poor quality of care. To provide adequate safeguards, the GAO is instructing Medicare to put more pressure on states to investigate all deaths of DD individuals, regardless of the suspected cause. The complete report can be found here.

It's worth mentioning that California's elder abuse laws apply equally to "dependent adults" which is any individual between the age of 18 and 64 who is in some type of custodial care. Frequently that includes developmentally disabled adults.

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Posted In: Assisted Living Facilities , Developmentally Disabled , Nursing Home Abuse and Neglect , Residential Care Facilities , San Bernardino Nursing Home

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Studies have suggested that approximately one-third of all nursing home residents suffer from some form of dehydration or malnutrition, a condition that can cause or aggravate more serious medical conditions, and may be caused by elder abuse or neglect.

Much of the problem can be attributed to poor staffing, whether inadequate numbers of staff, poor staff training, and a lack of individualized care. While California law requires 3.2 hours of certified nursing per patient, per day - a minimum number many nursing homes fail to meet - many experts believe the law is inadequate, advocating for an increase to 4.1 hours per resident, per day.

Karen Davis of the Commonwealth Fund, the funder of a report on nursing home care, says, “malnutrition, dehydration, and weight loss in nursing homes constitute one of the largest silent epidemics in this country."

Any signs or symptoms of malnutrition, dehydration, or sudden weight loss should be promptly reported to the director of nursing, and the resident’s regular physician. Any other questions can be directed to Walton Barber LLP, who would be happy to answer any questions or concerns about nursing home care.

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Posted In: Dehydration , Nursing Home Abuse and Neglect

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