California Nursing Home Abuse Lawyer Blog

All licensed nursing homes in California are licensed and certified by the California Department of Public Health, which conducts an annual inspection of every licensed skilled nursing facility in the state. In addition, the DPH is charged with the duty to investigate complaints of neglect or abuse, and issue the results of its investigation. Here is some general information about making a complaint against a nursing home.

First, who can make a complaint? Under California law, any person can make a complaint about a nursing home; it does not just have to be the resident, family member, or responsible party. Complaints may be made anonymously.

When is a good time to make a complaint? A complaint should be made whenever one considers the treatment problems to be serious enough to report. It is usually a good idea to express your complaints to the facility first, but if you feel like you're not being taken seriously, call DPH.

Where are complaints made? Complaints should be made at the nearest district office of the DPH. There are several offices in Southern California, and contact information can be found at the Walton Law Firm website by clicking here.

What information should I give DPH? In short, everything. Before you speak to an investigator, it's a good idea to write your complaint down so you don't forget anything. Focus on the facts, and not your own opinions about the situation.

As a complainant, you will be notified of the name of the investigator assigned to your complaint within two days of the date the complaint is made. In addition, the nursing facility may not retaliate against a resident for a complaint that is made. In fact, any type of discriminatory treatment made against a nursing home resident within 180 days of a formal complaint is presumed to be retaliatory.

For more information about making a complaint against a nursing home, visit the website of California Advocates for Nursing Home Reform. The CANHR page How To File A Complaint can be found by clicking here.

The nursing home abuse and neglect lawyers at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has been abused or neglected in the nursing home or assisted living setting. Cases are accepted in all Southern California counties, including San Diego, Orange, Riverside, Los Angeles, San Bernardino and Ventura. Call (866) 607-1325 for a free and confidential consultation

Nursing home abuse and neglect lawyers in California often lament the state's weak enforcement of bad nursing homes. The California Department of Public Health, due primarily to inadequate funding, rarely provides the strong oversight of California's 1,200 or so licensed skilled nursing facilities. As a result, bad nursing homes operate with relative impunity, and those who screw up rarely suffer the consequences.

Apparently California is not alone. In Connecticut, the director of the state's Department of Public Health said his unit is dangerously understaffed. He has only four investigators to oversee the state's 231 certified nursing facilities, and told the Norwich Bulletin that if he had 10 more, he would have a lot more cases.

State Sen. Edith Prague has apparently had enough. She is set to re-introduce a bill that would make it easier to hold the owners of nursing homes criminally responsible for abuse and neglect of patients in their facilities. Under Prague’s bill, the state's DPH would be required to include a notice in nursing home applications telling owners they could be held criminally liable for patient neglect by employees, including for things such as inadequate staffing. “You can’t sue the state, but the nursing home owners who cut back on staffing I feel should be held responsible,” Prague said.

The bill was partly motivated by the story of Robert Wininger, a Connecticut man who died after developing gangrene in both legs while residing in a nursing home. The family filed a wrongful death lawsuit, and named as a defendant the state's public health commissioner.

Do we need such a bill in California? At Walton Law Firm, we have seen many deplorable acts of neglect and abuse, many of which have been investigated by the state, only to result in a small slap on the wrist. Maybe the threat of criminal prosecution would force the repeat offenders to either sell to competent owners or get out of the business.

Source: Norwich Bulletin

The nursing home 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.

When a person has very serious concerns that a nursing home resident has been subject to abuse or neglect in the home, a complaint may be filed with the state. The California Department of Public Health (DPH) licenses and certifies all nursing homes in California, and maintains a process for investigating all complaints made against nursing homes.

The process of filing a complaint with the DPH is fairly straightforward, and the California Advocates for Nursing Home Reform have summarized it nicely:

1. Who Can File a Complaint? Any person, or even an organization, can file a complaint about nursing home neglect with the DPH. While it is usually a family member, it doesn't have to be.

2. When Should a Complaint be Made? Typically complaints are made after other measures to resolve the issue have failed. In cases of suspected abuse or neglect, it's best to file the complaint as soon as possible.

3. Where Do I File a Complaint? DPH complaints should be filed with the nearest DPH office, usually in your county. Click here for a list of DPH office numbers for all Southern California counties.

4. What Should I Say? Focus on the important issues. For example, if the resident has suffered numerous falls and been injured, but you also have been unhappy with room cleanliness, it's best to focus on the falls and injury. You can always discuss the room cleanliness issues later. The DPH gets many call of complaints against nursing homes, you want them to take yours seriously.

5. What Happens After I Make My Complaint? Under California Law, the DPH must commence an onsite investigation of the complaint with 10 working days from the date the complaint is made. After the visit, follow up investigation may be conducted, such as interviewing witnesses. The complaints are usually completed within 60 days, at which time you will receive written notice of the DPH findings.

6. Do I Need a Lawyer? It depends. If the complaint involves serious allegations of abuse or neglect, then contacting a nursing home abuse or neglect attorney might be a good idea. We frequently say that any unexpected injury, illness, or death could be a sign of neglect, and consulting an experienced attorney in California nursing home law might be a good idea.

Source: CANHR

The nursing home abuse and neglect attorneys at the Walton Law Firm LLP represent seniors and dependent adults who have been victims of physical or sexual abuse in the nursing home, and those who have been neglected or received substandard care. Call (866) 607-1325 for a free and confidential consultation.

Ninety-two-year-old Robert Doscher was admitted to Valley Gardens Health Care, a for-profit nursing home, on May 18, 2007. He came from a hospital where he was being treated for a mini-stroke, and other heart issues. Upon admission to the nursing home, he needed the use of a walker, and the plan was to stabilize his health, and transfer him to an assisted living facility.

He required the use of a walker when he was admitted, and it was initially planned that he could be discharged to a board-and-care facility when his condition stabilized. The admission assessment at Valley Gardens determined that Doscher was at "high risk" for falling, and the care plan ordered the he be checked "every one to two hours." He was also instructed not to get up without assistance, and a tab alarm was placed on his clothing to monitor his movements.

On May 21st, only three days after he was admitted to the nursing home, Doscher fell and struck his head on the floor. He was found by staff on the floor. According to the investigation, there was no evidence that Valley Gardens was checking on Doscher every one to two hours, nor did they place him near the nursing station, as had also been recommended upon admission.

Approximately three weeks later, on June 12, Dosher was again found on the floor, and, according to the medical records, Doscher "rapidly developed a change in condition manifested by agitation and then a decrease in his level of consciousness." The following day he was taken to the hospital in a comatose state, and died within 24 hours.

The California Department of Public Health was called to investigate Doscher's death, and issued a "AA" citation and a $90,000 fine for inadequate care that it found led to Doscher's death.

Valley Gardens is owned by Kindred Healthcare Inc. of Louisville, Ky. Kindred had revenue of more than $4 billion as of June 30, 2009 and operates 222 skilled-nursing facilities nationwide.

Source: Recordnet.com

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

A nursing home called Valley Gardens Health Care and Rehabilitation in Stockton, California has received an “AA” citation from the California Department of Public Health due the neglect of one of its residents. The AA citation is the most severe penalty that can be levied by the state, and is issued only when a patient's death has occurred in a way that can directly attributed to the conduct of the facility. A $90,000.00 fine was also issued.

According to news reports, which are currently scant on facts, the facility failed to ensure a resident was adequately supervised, resulting in a serious fall, which caused the resident to die.

The California Department of Public Health has the statutory authority license and certify all of California's nursing homes. Part of its authority is to inspect the homes annually, and respond to consumer complaints. If investigations into substandard care are substantiated, the CDPH has the authority to issue citation, and impose fines. Typically, the fine depends on the significance and severity of the substantiated violation.

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Source: KCRA

The nursing home abuse and neglect attorneys at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has been abuse or neglected in the nursing home or assisted living setting. Cases are accepted in all Southern California counties.

In a strongly worded report, the California Senate Office of Oversight and Outcomes recommended major reforms to the California long-term care ombudsman program. The responsibility of the Ombudsman program is to investigate and resolve complaints made by individual residents in nursing homes.

According to the California Advocates for Nursing Home Reform (CANHR), nursing home and assisted living facility residents in California at an increasing risk of elder abuse because ombudsman funding has been severely cut and the state ombudsman office has established unreasonable restrictions on ombudsman reporting of abuse.

The state report, entitled California’s Elder Abuse Investigators: Ombudsman Shackled by Conflicting Laws and Duties, revealed that ombudsman complaint referrals to the nursing home licensing agency dropped by a stunning 44 percent in the last year after the Governor Schwarzenegger slashed funding to the fledgling ombudsman program. Assisted living facilities have been affected as well. During the same period, complaints by ombudsman to California's Community Care Licensing regarding assisted living and residential care facilities also dropped by more than 40 percent.

According to CANHR:

The California Department of Aging operates the state ombudsman office, which is going to extreme lengths to prevent the proper investigation of abuse and neglect. The report states that the state ombudsman office will not even release the names of elder abuse witnesses to law enforcement or licensing agencies that are investigating the abuse, despite laws directing it to do so.

Source: California Advocates for Nursing Home Reform

The Walton Law Firm represents the elderly victims of neglect or abuse in the nursing home, residential care, or assisted living 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.

Tri-City Hospital in Oceanside was fined $25,000 by the California Department of Public Health for "failure to ensure the health and safety of a patient" who fell out of bed and fractured her hip. The hospital has modified its policies as a result.

According to reports, a 91-year-old woman who was admitted to Tri-City on December 7, 2008 because of a stroke, and paralysis on her right side, fell out of bed two days later and fractured her hip. She was taken to surgery for repair of the hip, and died the following day in the ICU.

The state investigation revealed that upon admission to the hospital the woman was rated as a high risk for falls; a rating that would require a series of interventions such as bed alarms, padding on the floor around the bed, etc. The investigation revealed that "there was no evidence in the medical record to support that these interventions were in place at the time (the patient) fell.

Tri-City has denied any wrong doing, and has submitted a "plan of correction," which has been accepted by the DPH.

Falls are a serious problem in many hospitals and nursing homes, and are the basis for many legal claims of malpractice and neglect. At this firm, we have prosecuted many nursing homes for injury-causing falls that, we alleged, should have been prevented.

Ten other hospitals in the state also received $25,000 fines, including: Sharp Chula Vista, Chula Vista; Alta Bates Summit Medical Center, Berkeley; Coast Plaza Doctor's Hospital, Norwalk; Kindred Hospital, Ontario; Loma Linda University Medical Center, Loma Linda; Los Angeles County Hospital, Los Angeles; Mendocino Coast District Hospital, Fort Bragg; Redwood Memorial Hospital, Fortuna; Saint John's Hospital and Health Center, Santa Monica; USC University Hospital, Los Angeles.

Source: North County Times

The San Diego elder abuse and neglect lawyers at the Walton Law Firm represent individuals and families who have impacted by malpractice, abuse, or neglect in the hospital, nursing home, or residential care setting. For a free and confidential consultation call (760) 607-1325.

A Tracy, California nursing home received a $100,000 fine and a AA citation, the state's most severe, after it was determined that the death of a 78-year-old resident was due to nursing home malpractice. The nursing home staff failed to monitor the woman's medication and failed to send her to the hospital when her brain started to bleed.

According to the report, the resident had recently received an increase in medication to prevent clots. With the medication came a potential for internal bleeding. Shortly after increase in dosage, the woman began to slur her words and complained of a headache. She kept saying, "My head, my head..." But nothing was done.

Several hours later the resident was semi-conscious, waking only to vomit. The family complained to the home that something was not right, but failed to take the matter seriously. The woman was eventually transferred to the acute-care hospital, but it was too late. She died in the emergency room.

The patient’s death was attributed to inappropriate bleeding secondary to medication. Bleeding in the brain was determined to be the cause of death.

The state of California issues only about 20 AA citations a year to the state's 1,300 licensed nursing homes.

Source: Tracy Press

The California elder abuse and neglect lawyers at Walton Law Firm LLP represent individuals and families who have suffered abuse or neglect in the hospital, nursing home, or assisted living setting. For a free and confidential consultation call (866) 607-1325, or fill out an online questionnaire.

A bill that will increase fines from $6,000 to $10,000 for individuals found guilty of placing an elderly person (over age 65) or a dependent adult in a situation where death or great bodily harm is likely has been signed by Governor Schwarzenegger. The bill, which will take effect January 1, 2010, will also increase penalties for those placing seniors in dangerous situations that are not likely to cause death or great bodily harm.

The new law was supported by Sen. Jenny Oropeza, who acknowledged that "Elder abuse for far too long has been a hidden, pervasive and deadly crime where out of 5 million recent cases, a shocking 84 percent went unreported." Under the new law, she said, "California's senior citizens and their families will rest easier knowing that my new law will help protect them from abuse."

Source: Long Beach Press-Telegram

The Southern California elder abuse and neglect lawyers at Walton Law Firm LLP represent individuals who have suffered abuse or neglect in the hospital, nursing home, or residential care setting. For a free and confidential consultation call (866) 607-1325.

Every year, nursing homes throughout the state of California are fined for deficiencies found in state investigations, frequently related to nursing home care. The fines range anywhere from a Class B fine of $1,000 to an AA citation of $100,000, as was recently issued against the Encinitas nursing home Aviara Healthcare.

But California officials concede that collecting these fines can take years, if they are collected at all. Nursing homes have a right to appeal fines that are issued, and most do. In the year 2007, the state issued more than $2 million in fines and to date has collected less than 10 percent.

The California Department of Public Health is charged with the oversight of skilled nursing facilities, and is the state department that issues and collects nursing home penalties. They simply don't have the manpower to get the job done.

"Because the department doesn't have enough attorneys, their appeal system is broken right now, they don't even have enough administrative law judges to process the appeals," says Pat McGinnis, director of the California Advocates for Nursing Home Reform."

The nursing home industry is using the system to its benefit. Because of under funded enforcement, nursing homes know that appealing any penalty presents an opportunity to either negotiate the fine down to a negligible amount, or will simply drag the matter on for years.

The nursing home malpractice lawyers at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has suffered from abuse or neglected in a nursing home or residential care setting.

The California Department of Public Health has issued fines to two Orange County nursing homes after concluding that negligent nursing care lead to the deaths of two residents. Alamitos West Health Care Center in Los Alamitos was fined $100,000.00, and Huntington Valley Healthcare in Huntington Beach was fined $80,000.00.

Investigators found that Alamitos West failed to give an 82-year-old female resident adequate fluid, causing her to suffer dehydration and kidney failure. When the woman was finally transferred to a hospital, her dehydration had caused an altered mental status. The woman died a week later, on Christmas Day.

The case against Huntington Valley involved the failure to call 911 as a patient was dying. According to reports, the caregiver thought the resident did not want resuscitation if life saving treatments was needed, but the resident had actually stated in his chart "I Do Want C.P.R." The resident died in the nursing home.

Alamitos West has said it will appeal the citation, while Huntington Valley told news reporters that it has not decided whether or not to appeal.

The nursing abuse and neglect 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.

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

The California Advocates for Nursing Home Reform (CANHR) have issued a press release addressing a Santa Monica nursing home that has neglected residents with impunity, and contending the state has done little to correct the problems. In the release, CANHR contends that a resident died while staff ignored breathing problems, another died from an infected bed sore, and a third was hospitalized with a neglected pressure ulcer, yet the home received no serious penalties from the California Department of Public Health who verified the neglect.

CANHR's concern about this is shared by many, including this law firm. We have had several cases of outrageous acts of abuse and neglect that have confirmed by the state investigation, but no serious penalties issued. Take for example a case we recently accepted. An elderly Alzheimer's patient is given a bath by caregivers at the nursing home where she resides. Because of her disease, she tends to resist care, and did resist when five caregivers tried to put her in the bath. One caregiver got so angry that she punched the resident in the face, causing a black eye and severe bruising. The resident couldn't complain because she cannot speak (because of her disease).

When the family asked why mom had a black eye, the facility lied and said she fell. It was only after one of the caregiver's conscious got the best of her when the incident was reported to the state. The state investigated and confirmed the abuse, but did the state issue a citation? Of course not; only a deficiency, and not for the physical abuse itself, but for the failure to report the abuse. But maybe the State didn't think the resident was actually “punched” or “struck” by the nursing; it doesn't use those words in its investigation report. Instead it says that the nurse "put her fist to the patient's face." No punch, no citation, no fine.

We have several more examples of this, as I am sure CANHR does, and most other nursing home abuse and neglect lawyers in California. As CANHR says:

It is common for DPH to issue very small fines for severe neglect and abuse. Of equal concern, DPH only collects a small percentage of the fines it issues to nursing homes. According to its records, it has collected less than a third of the fines it has issued in the last three years. Although California law and a court order obtained by CANHR require DPH to begin onsite investigations within 10 working days of receipt, the investigations of the two bedsore complaints were conducted 15 to 18 months after the complaints were filed.

To read the press release and to see copies of the DPH reports click here.

A Pico Rivera nursing home has been issued a $100,000 fine and an AA citation for the death of one of its residents in December. The California Department of Public Health announced that the citation was given to Riviera Healthcare Center on Telegraph Road after a 64-year-old man lit himself on fire while trying to light a cigarette.

According to reports, the resident, who was confined to a wheelchair after suffering a stroke, was left unattended in the dining room. When he caught fire, staff was alerted, but panicked, and failed to use a fire extinguisher and fire blanket that was just six feet a way.

The man was rushed to the nearby hospital with third-degree burns to his legs, groin, butt and hand. Skin grafts were attempted, but failed to take and the man died 18 days later.

This is Riviera Healthcare Center's first fine this year. Earlier it was issued a $20,000 find for an administrative violation.

The Los Angeles nursing home malpractice lawyers at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has been abuse or neglected in the nursing home or assisted living setting.

Escondido Nursing Center received the state's most severe citation – a AA – after the choking death of an elderly resident. According to reports, the 180-bed facility failed to modify the resident's nutrition plan after his physician placed him on a special diet because of chewing and swallowing difficulties. During lunch on November 30, 2008, the resident suffocated when food got stuck in his wind pile. He had been given beef and carrots.

Class AA citations are relatively rare in California, with only about 20 being issued annually. In our view, this isn't enough. As nursing home abuse and neglect attorneys, we have investigated numerous horrendous cases of neglect similar to this one (actually, many are worse), where an investigation is completed by the California Department of Public Health and no citation is issued. This may be a good sign that the new leadership at CDPH is changing the culture and encouraging the department to be more willing to enforce California state law as the people expect.

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

Just before leaving the White House, President Bush enacted a rule that designates state inspectors of nursing homes as federal employees, making it more difficult to obtain evidence obtained by those inspectors in private lawsuits against nursing homes for abuse or neglect, such as those pursued by Walton Law Firm LLP.

The new restriction affects about 16,000 nursing facilities in the United States, and will require litigants to go to greater lengths to obtain information that used to be routinely given. In short, the rule prohibits state health departments (such as the Department of Public Health in California) from participating in private lawsuits that are in the federal assistance program.

Bloomberg.com has more on the story here.

Lemon Grove Care and Rehabilitation (San Diego County) has received the state's most severe citation after the burn-injury death of a 74-year-old resident. State investigators found that the facility failed to adequately supervise the resident, who caught fire while smoking at the facility. According the reports, the woman was sitting in the designated smoking area trying to light a cigarette when her jacket caught fire. She died 10 days after suffering her injury.

The nursing home has been issued an "AA" citation and a fine of $80,000.00, which it intends to challenge in Superior Court. Lemon Grove Nursing and Rehabilitation received two Class B citations last year (click here), and is currently under investigation for separate allegations of neglect in a case being handled by Walton Law Firm LLP.

Walton Law Firm LLP represents individuals and families throughout Southern California in cases involving nursing home abuse and neglect. All consultations about a case are free and confidential.

Southern California legislators are supporting a proposal that would require nursing homes to post their ratings on the front door, much like health grades are posted at restaurants. Yesterday, Assembly Bill 215 was introduced in the California legislature to require that any nursing home that receive federal money to prominently display the rating it received under the federal government's recently unveiled five-star rating system.

“Posting nursing home grades is crucial to ensuring our loved ones receive the high quality of care they deserve,” State Representative Mike Feuer (D-Los Angeles) said in a statement. “This legislation will give families valuable information and provide an additional incentive to facilities to achieve the highest standards.”

Last month, Los Angeles County supervisors voted unanimously to require that any nursing facility that receives Medicare and Medi-Cal funding to post their ratings, and inform all new residents of the rating. The ratings are based on federal inspections, using three years worth of data.

To go to the federal ratings website click here.

The attorneys at Walton Law Firm LLP represent individuals and families who have suffered due to abuse or neglect in the nursing home setting. Cases are accepted throughout Southern California.

San Dimas nursing home Casa Bonita Convalescent Hospital was fined $121,000 by the Department of Public Health after the death of 88-year-old resident Rita Twomey. State regulators issued three citations after finding that caregivers turned off the alarm of a ventilator keeping the resident alive. When the ventilator malfunctioned, no alarm was sounded and the resident died.

According to reports, Twomey's daughter found her mother in bed with her lips and fingers blue. Tragically, the daughter tried to keep her 91-year-old father, whom she had brought for a visit, from going into the room. "They didn't even get to say goodbye," the daughter said. "That's the heartache."

The 106-bed Casa Bonita disputes the allegations made by the state, and intends on appealing the fines in Superior Court.

The Los Angeles elder abuse lawyers at Walton Law Firm LLP represents individuals and families throughout Southern California who have been injured or killed in the nursing home setting. Cases are against skilled nursing facilities, residential care facilities and assisted living facilities are accepted, and all consultations are free.

The California Long-Term Care Ombudsman Program is the state program responsible to investigate and resolve complaints made by individuals (or their representatives) residing in long-term care facilities such as nursing homes. Last week, when the California budget was signed by Governor Schwarzenegger, he cut state funding for the ombudsman program.

The decision has not gone over well with elder care advocates. The governor's cuts removes roughly 15% of the budget for the program, which translates into a loss of 1.25 of every 3.7 positions.

To contact your local ombudsman's office call the appropriate telephone number in the geographical area the incident leading to the complaint occurred.

Los Angeles
Region I Santa Monica (310) 899-1483
Region II Los Angeles (213) 617-8957
Region III Reseda (818) 757-1580
Region IV Pasadena (626) 793-3510
Region V Lakewood (562) 925-2346
Region VI San Dimas (909) 394-0416
Region VII Lancaster (661) 945-5563
Region VIII Burbank (818) 563-1957

Orange (714) 479-0107, (800) 300-6222
Riverside (951) 686-4402, (800) 464-1123
San Bernardino (909) 891-3928, (866) 229-0284
San Diego (858) 560-2507, (800) 640-4661

Walton Law Firm LLP represents people who have been victimized by elder abuse, elder neglect, mistreatment, and nursing malpractice. Cases are accepted in the counties of San Diego, Los Angeles, Orange, Riverside, San Bernardino, Ventura, and Imperial.

The New York Times is reporting this morning that 90% of all nursing homes were cited for violations of federal health and safety standards. Approximately 17% of U.S. nursing homes had deficiencies that caused actual harm. As mentioned in this blog previously, nursing facilities that operate "for-profit" were more likely to have problems than non-profit homes.

Federal inspectors received 37,150 complaints in 2007 about nursing home conditions, the bulk of which involved bed sores, abuse and neglect of residents, medication errors, and nutritional issues. Failure to sufficiently staff was noted as a particular concern in the report, including the allegation that nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” Not surprisingly, researchers learned that elderly patients receive better care at homes with a higher ratio of nursing staff members to patients.

The U.S. has approximately 15,000 nursing homes, housing nearly 2 million people. Under the laws of most states, including California, these homes are inspected once a year.

The elder abuse lawyers at Walton Law Firm LLP, a Southern California law firm, represents individuals who have been impacted by the abuse of elders and dependent adults while under professional care. All consultations are free, and cases are accepted in all Southern California counties.

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

Nursing home residents have clearly defined rights when it comes to being transferred or discharged from a nursing facility, and may be evicted or moved under certain circumstances. Under California law, a nursing home may discharge or transfer a resident only if:

1. the resident's health has improved and is no longer need of skilled nursing services;
2. the resident's needs can no longer be met in the nursing home;
3. the health of individuals would be endangered;
4. the resident has failed, after reasonable notice, to pay; or
5. the nursing home ceases to operate.

Any discharge or transfer must be supported by adequate documentation, and the records must contain accurate assessments of the resident's condition. In addition, before any transfer or discharge can be made, the facility must provide written notice to the resident and, if known, a family member.

Unfortunately, nursing homes will frequently try to discharge (or "dump") residents they view as undesirable, for whatever reason. Any person who believes that they or someone they know has been the victim of a wrongful discharge or transfer may file complaint with the California Department of Public Health (Click here for contact information).

Walton Law Firm LLP represents individuals who have suffered abuse or neglect in the nursing home and assisted living setting. Cases are accepted in San Diego County, Riverside County, Orange County, San Bernardino County, and Los Angeles County.

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

Yesterday the Bush Administration announced that it will create a nursing home rating system by the end of the year. The criteria for ratings has not yet been established, but will likely be a combination of state and federal inspection reports, staffing reports, and resident and family satisfaction surveys. The ratings would be placed on a government website.

"The fact a home has a lower rating will likely put them on the path to improvement," said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services. "I don't think we're going to see many people who are very anxious to put a loved one in a one-star home."

Those looking for information about California nursing homes already have a few options when looking at prospective homes. The California Advocates for Nursing Home Reform have a nursing home guide resource, and the California Healthcare Foundation has its own rating system. Both use the government surveys and staffing reports as a basis for the rankings, so the accuracy of the ratings is based primarily on the government's information, which can be notoriously unreliable.

As we have said in previous posts, the best way to choose a nursing home is to look at the government surveys, and to visit the home on more than one occasion and speak with current residents and their families.

The law firm of Walton Law Firm LLP represents victims of nursing home malpractice. It accepts cases in all Southern California counties, including Los Angeles, Orange, Riverside, San Diego, San Bernardino, Ventura, and Imperial.

A nursing home in Anaheim has received a $50,000 fine in the choking death of a resident. The resident, a brain injured man in his forties who had swallowing difficulty, choked on a piece of burrito.

According to reports, a caregiver was preparing the man's meal at Parkview Healthcare Center when he reached for the burrito and put it in his mouth. When he began choking, the Heimlich maneuver was attempted but failed. Caregivers were then instructed to begin CPR, but before doing so, looked in the resident's file to determine to see of there was a DNR (do not resuscitate) order. There was.

A doubtful nursing then called the man's sister, telling her "your bother is turning black, do you want him revived?" When the sister responded "yes." The DNR order was wrong. CPR was started. The man was pronounced dead approximately 30 minutes later. The fine was issued due to the nursing facility's failure to provide "prompt emergency medical care" as requested by the resident.

This was the second time in recent months that the Department of Public Health has fined an Orange County nursing home for a choking death. In April, Palm Terrace Healthcare in Laguna Hills received a fine of $75,000 after a patient drowsy from morphine was given meat and choked to death in her room.

The son of Maria Cobian, the elderly woman who was hit by a car and killed when she wandered away from her nursing home, has filed a wrongful death lawsuit in Vista Superior Court.

The lawsuit alleges that Palomar Heights Continuing Care Center in Escondido negligently failed to supervise Ms. Cobian, and to ensure the safety of 94-year-old resident, who also suffered from dementia. Ms. Cobian was only a few hundred yards away from the nursing facility when she walked into traffic and was struck by a car. The company of the car that hit Cobian was also named in the lawsuit.

Despite her alleged documented history of trying to leave the facility, and the nursing home's failure to prevent it, it doesn't appear that there are allegations of elder neglect under the Elder Abuse and Dependent Adult Civil Protection Act against the facility, which allows for enhanced damages against nursing homes, including pre-death pain and suffering, when certain burdens of proof are met.

Earlier this year, the California Department of Public Health issued a Class AA citation against the facility and fined it $100,000 for violations that caused Cobian's death. It was the second AA citation against this facility in two years. In 2006 a resident burned to death after being allowed to smoke next to his oxygen tank.

The California Advocates for Nursing Home Reform has issued its 2007 Nursing Home Citation Report. CANHR has prepared a citation summary, including the name of the nursing facility, the date, the level of citation, and a brief summary of the facts that led up to the citation. There is also an instructional key to help readers understand how the individual nursing home citations summaries are displayed. The report, which is broken down by California counties, can be found here. (.pdf)

In summary, a total of 651 citations were issued against nursing homes in California by the Department of Public Health in the year 2007, 22 of which were Class AA citations (violations caused a death), and 122 were Class A (violations present imminent danger and a substantial probability of death).