California Nursing Home Abuse Lawyer Blog

The California Advocates for Nursing Home Reform (CANHR) has launched a comprehensive website that addresses the growing problem of drug misuse in California nursing homes. Every day, approximately 25,000 California nursing home patients are given an antipsychotic drug. Half of all dementia patients are administered these drugs despite FDA warnings these drugs can kill a dementia patient.

Because of this CANHR has launched a campaign to help end the drugging of California nursing home residents. CANHR states its goal this way:

The goal of the campaign is to stop nursing homes and doctors from misusing dangerous antipsychotic drugs and other types of psychoactive drugs to chemically restrain residents and to replace drugging with individualized care. Through education, advocacy and political action, we seek to bring Californians together to end this harmful practice.

The website is a great resource for families and professionals, and invites people to get involved in the campaign.

VISIT THE WEBSITE HERE

Also on the new website you'll have access to CANHR’s guide, Toxic Medicine: What You Should Know to Fight the Misuse of Psychoactive Drugs in Nursing Homes. This comprehensive booklet addresses all of the uses of psychoactive drugs in skilled nursing facilities, and provides guidance for residents and their families to avoid becoming a victim of these drugs.

CLICK HERE TO DOWNLOAD TOXIC MEDICINE: WHAT YOU SHOULD KNOW TO FIGHT THE MISUSE OF PSYCHOACTIVE DRUGS IN NURSING FACILITIES [.pdf]

The elder abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults who have been abused or neglected in the skilled nursing facility, residential care facility for the elderly, and assisted living setting. Cases are accepted in all Southern California counties. Call (866) 607-1325 for a free and confidential consultation.

SmartMoney.com has an article out entitled 10 Things Nursing Homes Won't Tell You. Which has been adapted from the book "1,001 Things They Won't Tell You: An Insider's Guide to Spending, Saving, and Living Wisely," by Jonathan Dahl.

Walton Law Firm thought you might like to see the list:

1. “We’re careless about the drugs we give out.”

The use of antipsychotic medications inside the nursing home has exploded in recent years, and has been discussed at length here. In California, nearly 60% of all California nursing home residents are given psychoactive drugs, a 30% increase since 2000, according to California Advocates for Nursing Home Reform. It's become a real problem.

2. “We’re woefully understaffed.”

Staffing is the biggest problem in nursing homes today. According to Donna Wagner, a professor at Towson University, it is a "crisis." While it is optimal to have one caregiver for three to five residents, some nursing homes have one registered nurse for 50 to 60 residents.

3. “Mr. and Mrs. Smith, meet Sticky Fingers Louie.”

Nursing home charges can be ridiculously expensive. In 2009, a year of nursing home care cost over $70,000 for a semi-private room according to the Department of Health and Human Services.

4. “What you don’t know about your checkbook can hurt you.”

There are too many thefts in nursing homes (frequently by the employees).

5. “If it’s not in the care-plan, we’re not gonna do it.”

California nursing homes must prepare a "plan of care" for every resident, and then update it on a regular basis. The failure to provide a comprehensive care plan was the primary source of deficiencies issued against California nursing homes last year. It is supposed to be detailed, and address the specific needs of the patient, but too frequently is a generic plan that fails to address (and provide) for the residents’ special needs.

6. “‘Neglect’ is our middle name.”

In January of this year, the California Department of Public Health issued a citation to an Orange County nursing home, along with an $85,000 fine. The citation alleged that a resident died after falling and suffering a fatal head injury. The resident of falls, but the nursing home failed to take adequate precautions.

The neglect of a nursing home resident can be revealed in a variety of ailments, including pressure sores / ulcers, dehydration, infections, weight loss, fractures, etc.

7. “We use physical restraints on your loved ones.”

While it is not illegal to use physical restraints, they are supposed to be used only as a last resort, and only with a physician's authorization. In 2008, 10.97% of California facilities that received deficiencies did so for use of illegal restraints.

8. “Take our report cards with a grain of salt.”

Survey reports and nursing home ratings systems rarely tell the true story. It is well known that nursing facilities and tipped off and prepare for their annual visit from state inspectors. The never look or operate as well as they do for the week they are being evaluated.

9. “Fines? Go ahead— give us your best shot.”

Does a citation and a fine sting? Not really. In California, only $1.2 million of the $4.6 million assessed in fines was actually collected. Most homes appeal the citations as far as they can, they agree to a settlement where they pay much less.

10. “We can kick a resident out anytime we want.”

When the resident is too difficult, or requires too much care, the nursing home can always just evict them. This was the No. 1 complaint received by the State Long Term Care Ombudsman for New York in 2009, and is also an issue in California. Facilities must follow strict state guidelines, but beyond that there is no problem discharging residents to different facilities.

Source: SmartMoney.com by Lisa Scherzer and David Stires

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults throughout Southern California who have been abused or neglected in the skilled nursing facility, residential care facility for the elderly, and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

Last year, the U.S. Drug Enforcement Administration began investigating allegations that some nursing homes were dispensing powerful narcotics to nursing home residents without a physician order. Because of the new scrutiny, however, nursing home and hospice trade organizations are arguing that many patients are now being left without pain medication as the nursing facilities try to find ways to comply with DEA regulations. Congress has also taken notice, and the subject will be addressed at a Senate hearing today.

The DEA intensified its efforts to battle abuse of prescription drugs in nursing home, after numerous reports of overmedication of patients in nursing facilities, many without prescription, and frequently used as a "chemical restraint," not to treat a specific illness. In a letter to Congress last December, attorneys for the DEA said that allowing nurses to dispense medications without a doctor's order, "trivializes the doctor-patient relationship and weakens the quality of care for the frail and infirm."

Nursing home trade organizations, however, say that long-term care facilities don't make available enough doctors to issue prescriptions every time. The DEA's requirement on "hard copy prescriptions," it says, places burdens on prescribers, pharmacists and nurses, and can lead to extended delays in the administration of pain medication."

Source: Wall Street Journal

The nursing home abuse and neglect lawyers at the Walton Law Firm represent elders and dependent adults throughout Southern California who have been abused or neglected in the skilled nursing facility, residential care facility for the elderly, and assisted living setting. Call (760) 571-5500 for a free and confidential consultation.

In 2007, Dr. David Graham, a drug safety expert with the FDA, testified before Congress and stated that approximately 15,000 people die each year in U.S. nursing homes from the off-label use of anti-psychotic drugs. Off-label use is the use of the drug for a condition it was not intended. In California, it has been estimated that up to 60% of all nursing home residents are given psychoactive drugs, which is an increase of 30% in only 10 years. It's no wonder that when we think about nursing homes, we think of isolated elderly people sitting hunched over in wheelchairs, or in bed, segregated from the world. That life is a sad realty for many.

To combat the misuse of psychoactive drugs, the California Advocates for Nursing Home Reform have released a publication called Toxic Medicine - What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes. The 20-page booklet provides an overview of what psychoactive drugs are, their purposes, the risks associated with them, and an overview of the resident's rights.

Primary among those rights is the requirement of consent. Before a psychoactive drug can be used, a physician must inform the resident (or his/her decision-maker) about the drug, why it is being recommended, and the risks associated with it, and then must obtain consent before prescribing it. The guide also provides a list of questions that should be asked of a doctor who is recommending a psychoactive drug, and what to do if it is suspected that the drugs are being used without proper authority.

The California Advocates for Nursing Home Reform is a San Francisco based nonprofit dedicated to improving the lives of long-term care patients since 1983.

A .pdf of the Toxic Medicine booklet can be found by clicking here.

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults who have been abused or neglected in the nursing home and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

This story is flat-out disturbing, and started with a concern we have heard many times from the families of our nursing home abuse clients. It began with Phyllis Peters could not wake up her 97-year-old mother, who was residing in Kern Valley Nursing Home. When she complained to Gwen Hughes, the nursing home's director, Hughes would "chemically restrain" the patient by giving her powerful anti-psychotic drugs to shut her up. Hughes did this to other residents in the nursing home, and three of them died.

In a report from the California Attorney General, Hughes ordered one patient drugged because she "glared" at her. Another was given high doses of an anti-psychotic drug for throwing a carton of milk. Several residents became severely malnourished, and were left in bed drooling and emaciated.

"In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet," said AG Jerry Brown.

But here's the stunner. Hughes had been fired from a previous nursing home for over-drugging there. When the previous employer was called as a reference for the job at Kern Valley, they failed to explain why Hughes was terminated out of fear of lawsuits (ironically, since now they will become a part of a huge lawsuit). As a result of the deaths, Hughes, administrator Pamela Ott, and physician Hoshang Pormir have been charged with criminal elder abuse, all facing up to 11 years in jail. Lawsuits by the surviving family members, and probably others, are certain to follow. The FDA estimates that unnecessary anti-psychotics kill 15,000 nursing home patients each year.

Source: ABC News

The Pasadena elder abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults throughout California who have been abused or neglected in the nursing home and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

The Chicago Tribune recently published a brief article called 5 Things to Know about Psychotropics, which I thought I would pass along to you. Here are the five things:

Your rights: A nursing facility cannot administer a psychotropic drug without a physician's order, which by law requires informed consent and a legitimate diagnosis. The standard of care requires that nursing staff must first try to calm patients, and other possible causes of agitation must be ruled out, such as infection.

The consent: Before psyschtropics can be used consent must be obtained by the "responsible party" of the resident, usually the person with power of attorney. The consent must be in writing.

The drugs: What are psychotropic drugs? Psychotropics generally include antipsychotics, antidepressants and anti-anxiety drugs. The antipsychotics generally pose the greatest risks to nursing home residents. Remember, antipsychotics are intended to treat serious mental illnesses, such as schizophrenia, but doctors may prescribe them for other uses. They cannot be used as a "chemical restraint."

The risks: As stated, psychotropic drugs are powerful, and can cause drowsiness, dizziness and confusion. This, in turn can lead to falls, dehydration, and extreme lethargy.

To complain: As a first step, contact the nursing home's administrator. If you are not getting the answers you need, contact the local ombudsman's office or the California Department of Public Health. Telephone numbers for the offices of the ombudsman and CDPH in all Southern California counties can be found by clicking here.

Source: Chicago Tribune

The Walton Law Firm represents seniors and dependent adults who have suffered neglect or abuse in the nursing home, residential care, or board-and-care setting. Cases are taken in all Southern California counties. For a free and confidential consultation call (866) 607-1325, or fill out an online form.

The administrator of Kern Valley Hospital was charged eight counts of felony elder abuse this week after permitting caregivers to forcibly administer psychotropic drugs to residents out of convenience and not medical necessity. One resident died because of the practice.

Since 2006 the director of nursing at Lake Isabella nursing home has allegedly ordered caregivers to administer high doses of psychotropic medications to Alzheimer's and dementia patients to control their behavior and make them easier to care for. This use of medications as a "chemical restraint" is illegal, and will likely expose the nursing home to civil lawsuits in addition to the criminal charges that have been filed.

According to news reports, three residents may have died as a result of the practice. The residents who died were Mae Brinkley, 91, Joseph Shepter, 76, and Alexander Zaiko, 85.

Last February three other employees were arrested and charged in the case, all of whom worked for the Kern Valley Healthcare District nursing home in Lake Isabella.

Source: Bakersfieldnow.com

The elder abuse lawyers at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has been abuse or neglected in a Southern California nursing home or assisted living facility.

Three California nursing home employees were arrested yesterday for allegedly injecting 22 residents with mood-altering drugs to keep them quiet and restrained. According to the criminal complaint, a nursing director, a pharmacist, and a physician drugged the residents in order to keep them compliant and easier to care for. Three of the patients died.

“These are powerful medications that were given, in some cases against people’s will, primarily for management, not health reasons,” said California Attorney General Jerry Brown. “It's unconscionable behavior and it’s certainly not what people expect when they entrust their parents or grandparents to a skilled nursing home.”

The allegations in the criminal complaint are appalling, including residents becoming "zombie-like" and unable to eat or drink for days, causing severe malnutrition and dehydration. The three residents who died were Fannie May Brinkley, Eddie Dolenc, and Joseph Shepter. At least one civil lawsuit has been filed as a result of the deaths, and more are expected.

The use of powerful narcotics as chemical restraints is an ongoing problem in nursing homes. Under California law, a resident, or his/her responsible party must be thoroughly informed about the risks associated with anti-psychotic medications, and must approve any request for us. These medications must also be administered only with a doctor's order.

New research shows that elderly people suffering from dementia who are given antipsychotic drugs are more likely to end up in a hospital or die, even if the drugs are administered for a very short period of time.

Antipsychotic drugs are frequently used in nursing homes to address the behavioral issues caused by dementia, including aggression, agitation, and delirium. Physicians concede that alternatives to antipsychotics to address this type of behavior are limited.

Many experts feel behavioral interventions should be tried first and antipsychotics used as a last resort, "when the behavior or the psychiatric symptoms are really out of control and causing complete distress not only for the person suffering from Alzheimer's, but for caregivers all around them," said Maria Carrillo, director of medical and scientific affairs at the Alzheimer's Association in Chicago. "It's important to work these things out with the physician and, of course, do follow-up very closely together, so you can make sure these antipsychotics are having the effect you want and, if not, discontinue them immediately."

The study's findings were presented in the most recent edition of the Archives of Internal Medicine.

Medicaid spends more money on antipsychotic drugs than any other prescription drug. Physicians are prescribing these powerful drugs in record numbers to nursing home residents in order to control their behavior, not for the treatment of psychotic illness.

It is reported that nearly 30% of the total nursing home population is receiving medication in a practice that is known as "off label use" of prescription drugs. It's no surprise to lawyers who practice this area that studies also reveal that nearly 21% of nursing facility residents being given these drugs do not have a psychosis diagnosis.

"You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they're out of it, and that is unacceptable," says Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging, a not-for-profit industry group. Her research, which she believes reflects national trends, shows that about one-third of dementia patients in New York's nursing homes are on antipsychotics; some facilities have rates as high as 60% to 70%. "These drugs are being given way too much to this frail elderly population," Dr. Teigland says.

Here at Walton Law Firm we frequently get calls from families angry at nursing providers for over-medicating loved ones. It's usually a similar story. The family stops by the facility for a visit, only to find their loved one non-communicative and listless, and sometimes incontinent.

The Centers for Medicare & Medicaid -- the federal agency that oversees the two huge tax-funded insurance programs that cover the elderly and the poor -- has "initiated a more rigorous process to oversee appropriate use of medicine," says Chief Medical Officer Barry Straube. He says the number of nursing home inspections that result in citations for violating drug-misuse rules has jumped by nearly 50% between 2004 and this year. Action is being taken and the increased vigilance is working, CMS says.

Dr. Straube says CMS -- which both funds and oversees nursing homes -- "is very concerned about the quality of care in nursing homes and has taken steps within its authority to discourage inappropriate use of all drugs, including psychotropic medications."

High use of antipsychotics in a nursing home can be an indicator of inadequate staffing or other negligent care, says Bruce Pollock, president-elect of the American Association of Geriatric Psychiatry. "We know the more staffing there is and the higher quality of care, the less the antipsychotic usage," he says.

If you have concerns that someone you know is being over-medicated contact the resident's primary physician immediately.