California Nursing Home Abuse Lawyer Blog

The nursing home industry (and nursing home lawyers) was stunned earlier this year when a Humboldt County jury returned a class action verdict against the nursing home chain of $677 million dollars. The plaintiffs alleged, and the jury believed, that Skilled Healthcare, the owner of many nursing homes in several states, routinely understaffed its California nursing facilities, compromising patient care in an effort to maximize profits.

The case was a battle. ”Everything was fought tooth and nail,” Timothy Needham, lead trial lawyer for the team of plaintiff lawyers told the Times-Standard. The trial lasted six months. But the verdict was so big it created practical problems for the victors, and potentially fatal concerns for Skilled Healthcare, a publically traded company. Because of the size of the verdict, Skilled Healthcare could not afford to pay such a huge judgment and could not appeal the result (appeals require the posting of a bond, which is a percentage of the verdict), and the plaintiffs really didn't want to take over the company. So, smartly, everyone agreed on a settlement.

It was announced yesterday that the verdict of $677 million was settled for $62.8 million.

As part of the case, the court granted an injunction, which will require that the nursing facilities maintain at least 3.2 hours of nursing care per patient, per day, as required by law, and requires that a third party be hired to monitor all of the nursing homes implicated in the lawsuit. The injunction will last two years.

For advocates on behalf of nursing home victims this was great news.

”From an advocate's standpoint, it's great. I would hope this makes a real difference in these patients' lives, and becomes a standard in the future,” said Pat McGinnis, executive director of California Advocates for Nursing Home Reform, adding that the agreement was the most substantial injunction the state has ever seen. “It's just so unusual. They've never had anything like this.”

Source: Times-Standard

The nursing home elder abuse and neglect lawyers at Walton Law Firm provide free consultations to individuals and families throughout Southern California who believe a loved one has been abused or neglected in the nursing home, assisted living, board and care, or home health care setting. Call (760) 571-5500 or (866) 607-1325 for a free and confidential case evaluation.

A beleaguered nursing home operated by the Motion Picture and Television Fund was fined by the California Department of Public Health for failing to prevent a serious injury to an 87-year-old resident. The resident was injured in May of last year when, while transferring the resident with a mechanized lift, the resident slid out of the lift and fell to the floor, causing a wound so large that it revealed her cranium.

After its investigation, the DPH concluded that the nursing home failed to follow a plan of care that was designed to prevent the resident, who suffered from Parkinson's disease, from falling. The home was issued an "A" citation and a fine of $7,500.

The citation comes at a time when the nursing home operators, a charity, have decided to close down the home. Currently the home has only 54 remaining long term care residents, which remains open only after protests from current residents and their families.

Despite concerns from families that the incident may have been the result of an "atmosphere of indifference" by staff after learning that the home will be closed, its owners have assured residents that is not the case. Steve Honig, spokesman for the Fund, said the incident happened "because an employee did not follow the proper procedure. Since then, the employee has been appropriately counseled and the resident involved in the situation is doing just fine."

Michael Connors from the California Advocates for Nursing Home Reform told the Los Angeles Times that harsh citations like the one received by the home are rare, and that insufficient staffing was likely the case. This is a charge that the facility flatly denies.

Source: Los Angeles Times

The nursing home abuse and neglect lawyers at Walton Law Firm 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.

The Sacramento Business Journal is out with an article accusing the State of California of exposing elderly nursing home residents to dangerous caregivers because state regulators have failed to implement a 2006 law that requires the creation of a centralized database for background checks on all long-term caregivers.

According to the article, an investigation by the state's Senate Office of Oversight and Outcomes discovered at least 20 incidents where individuals who lost their certification as nursing assistance because of wrongdoing were cleared and hired in a different facility.

“There is no excuse for allowing people with known histories of abuse to work in residential care facilities for the elderly or as caregivers in any other setting,” said Michael Connors, an advocate with California Advocates for Nursing Home Reform, a non-profit that advocates on behalf of nursing home and residential care residents.

One San Diego example provided in the report involved a certified nursing assistant who tried to transfer an 81-year-old nursing home resident by herself from bed to the shower. The resident's care-plan required two CNAs for all transfers. The resident fell, but the CNA never told a supervisor of the fall (presumably out of fear she would get in trouble). The resident's left hip was fractured in the fall, which went undiagnosed for an extended period of time. The resident died two months later. (Walton Law Firm has handled this very type of case - fall with undiagnosed fracture - many times.)

The regulation of nursing home workers has become a serious issue in California, with the growing number of elderly, and the explosion in growth of residential care facilities for the elderly. As of 2008, there were 7,648 RCFEs in California, an 18% jump in just four years.

To read the entire report from the Senate Office of Oversight and Outcomes click here (.pdf).

Source: Sacramento Business Journal

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, long-term care, residential and home care setting. Call (866) 607-1325 for a free and confidential consultation.

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

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.

If you considering using the services of a residential care facility for the elderly or an assisted living facility, you may be wondering how to select a good one. Unfortunately, there is no rating system like you might find in hospitals, and now nursing homes, but there are actions you can take that will help ensure you make the right choice.

The California Advocates for Nursing Home Reform (CANHR) have created a checklist to use when researching care facilities for the elderly. First and foremost, evaluate the most recent inspection report from the California Department of Social Services, Community Care Licensing (DSS). Your local DSS office will have a complete inspection file on every facility within its jurisdiction, and you have a right to review. Simply contact the office and make an appointment to go review the file. (Click here to find your local DSS office).

When reviewing the file, you want to make sure to examine:

● The inspection report. How did the facility do? Were there deficiencies, and, if so,did they involve resident care?
● Any complaints made against the facility in recent years, and how those complaints were addressed.
● Request to see the "Advisory Notes," form of written consultation provided by the licensing evaluator to the facility.

In addition, use the CANHR checklist to get a good idea about the day-to-day life in the facility, and to determine which home is best for you:

● Visit each facility several times.
● Pay special attention to how residents are being treated by staff and the quality and responsiveness of the services. Don't be sold only on the attractiveness of the facility.
● Narrow the options down to two or three facilities.
● In making visits, walk through the whole facility and visit at different times.
● Drop by unannounced and visit at night and/or on the weekend.
● Make sure that you visit during a mealtime.
● Obtain a copy of the admission agreement. Read it carefully. Understand the services, costs and conditions for transfer.

Click here to see the entire CANHR checklist.

Before making the decision, do your homework. You may be preventing a major headache down the road.

The San Bernardino 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 skilled nursing facility, residential care facility for the elderly, 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.

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.

If you or a loved one is being threatened by eviction from your assisted living facility (or residential care facility), it is important to know that the law is on your side. Under the California Code of Regulations, an assisted living resident can be eviction for only five reasons:

1. A failure to pay rent within 10 days of its due date;
2. Failing to comply with state or local law (e.g. using illegal drugs, assault/battery, etc);
3. Failing to follow the facilities written policies and procedures (which must be stated in the admissions agreement);
4. After a formal assessment (usually by a doctor), the facility determines that it can no longer meet the resident's needs: or
5. The facility changes its purpose and will no longer be providing assisted living care.

In the event you or a loved on fall into one of the above-reference categories, the facility cannot just throw you out on the streets. Under the law, it must give you 30-days written notice of its intend to evict, unless you've lived there more than one year, at which point it must give 60-days written notice. In addition, that written notice must state clearly, and with factual detail, the reasons for the eviction.

If actions are being taken to evict , and you believe you do not fall into one of the five supporting reasons, it is recommended that you contact the local Ombudsman Program for direction and advice. A list of numbers for the Ombudsman in all Southern California counties can be found on the Walton Law Firm nursing home resource page by clicking here.

Source: California Advocates for Nursing Home Reform

The nursing home abuse and neglect attorneys at the Walton Law Firm represent individuals and families who have been abused or neglected in nursing homes and assisted living facilities throughout Southern California. Call (866) 607-1325 for a free consultation.

Governor Schwarzenegger has vetoed SB 303, a proposed law that would require doctors to inform residents about the dangers of psychotropic medications, and require nursing homes residents to give consent before such drugs can be given.

According to the California Advocates for Nursing Home Reform (CANHR), the use of psychoactive drugs has become an epidemic in California. According to one study, nearly 60% of all California nursing home patients are administered psychoactive narcotics, a huge increase from only a decade earlier.

Governor Schwarzenegger admitted that misuse of antipsychotic drugs is a serious problem in nursing homes when he vetoed the legislation, and even cited a study that found more than have of all residents on psychoactive drugs are in violation of federal guidelines.

“It is shocking that the Governor is protecting doctors and nursing homes that are drugging tens of thousands of elders with dementia into submission,” said Patricia McGinnis, CANHR’s executive director. “Thousands of nursing home residents will continue to die from these deadly drugs.”

SB 303 was sponsored by CANHR and received the support of many statewide organizations, including AARP, Alzheimer’s Association, California Alliance for Retired Americans, California Senior Legislature, Congress of California Seniors, Consumer Attorneys of California, Bet Tzedek Legal Services, Advocacy, Inc., Foundation Aiding the Elderly, Gray Panthers Sacramento, and Older Women’s League of California.

Source: CANHR

The nursing home abuse and neglect attorneys at the Walton Law Firm represent individuals and families who have been abused or neglected in nursing homes and assisted living facilities. Call (866) 607-1325 for a free consultation.

After 15 years of bouncing from nursing home to nursing home, and living with the indignities, the mother of a quadriplegic and brain injured daughter had had enough. On Sunday, September 13, Diana Harden wrote a note to a television news station exposing the problems she encountered trying to care for her daughter, then went to the nursing and shot her daughter to death, before turning the gun on herself.

In her letter to ABC news in the San Francisco Bay area, Harden spoke of the years of abuse and neglect her daughter endured in her nursing home. Yvette Harden, suffered a major brain injury and quadriplegia in a car accident 15 years earlier, and spent the last six years at the Oakland Springs Care Center. Oakland Springs is a nursing facility that had 54 complaints lodged against it in 2008 (which is an astonishing amount), and hundreds of deficiencies.

The letter attempts to explain, "the deaths of my daughter and myself." In it, Harden says that that nurses called her daughter a "big fat pig," and that they would "wash her like a car" in the shower. To punish the daughter, Harden claims, the water would be turned cold until she screamed. As a result, Harden wrote that her daughter has been "begging" her to end her life for over two years. The stress was too much.

Pat McGinnis, of the California Advocates for Nursing Home Reform, was outraged. "If nothing else, let's heed this mother's cry and say 'let's do something not just about the people that are in nursing homes, but let's do something about keeping people out of nursing homes in the first place,'" McGinnis said.

Source: ABC7

The elder abuse lawyers at the Walton Law Firm represent individuals and families who have been abused or neglected in nursing homes and assisted living facilities. Call (866) 607-1325 for a free consultation.

Los Angeles - The death of an 88-year-old nursing home resident has resulted in an AA citation and a $100,000 fine, the most severe penalty that can be imposed by California regulators. The California Department of Public Health issued the penalty after it concluded that nursing home resident's death was the result of neglect.

According to reports, the resident had received a gastrostomy tube (or g-tube) for feedings on August 29, 2008 and was admitted to Arbor View nursing home on September 3, 2008. The feeding tube became dislodged approximately one week later, and a nurse attempted to reinsert it. Unfortunately, the nurse missed the stomach, and instead inserted the tube into the abdominal cavity. Feedings were then continued.

The next day, the resident was rushed to the hospital with nausea and vomiting, and a scan revealed the problem. She had massive amounts of feeding material in her abdominal cavity that doctors tried to remove. The elderly resident contracted an infection and died shortly there after.

Walton Law Firm LLP has had this very case on two separate occasions; one, against a Riverside County nursing home, where a g-tube reinsertion failed, resulting in the death of the resident, and the other against a San Diego acute-care hospital.

Source: California Advocates for Nursing Home Reform

The Los Angeles nursing home abuse and neglect attorneys at Walton Law Firm LLP represent seniors who have suffered neglect or malpractice in the hospital, nursing home, or residential care setting. For a free and confidential consultation call (866) 607-1325.

Last Friday, Governor Arnold Schwarzenegger signed Assembly bill 392, which provides funding for California's long-term care ombudsman programs. The bill does not restore entirely the cuts that were made last year, but the $1.6 million appropriation to approximately 36 agencies throughout the state will provide sorely needed money to programs that, only weeks ago, were on the brink of dissolution.

"This legislation could make the difference between life and death for nursing home patients facing abuse or neglect. Now patients and their families who depend on the Ombudsman to monitor facilities and investigate key complaints can rest a little easier," said California Assembly member Mike Feuer.

Last year's cuts were exemplified in several high profile cases of nursing home abuse and neglect. In June 2009, a nursing home facility owner and a caregiver were arrested on suspicion of criminal abuse and neglect when a resident suffered from pressure sores so severe they led to a fatal infection.

The population of elder adults in California is expected to grow to 6.5 million by 2010, and to 9 million by 2020.

Source: California Chronicle

The attorneys at Walton Law Firm LLP prosecute nursing homes for the abuse and neglect of its elderly residents. Call (866) 607-1325 for a free and confidential consultation.

Unlike nursing homes, residential care facilities or assisted living facilities are not subject to the same regulation and government oversight. One can't simply log on to the myriad of nursing home evaluation websites to look at the latest inspection reports or complaint investigation. So how do you adequately evaluate a residential care facility before moving in?

The California Advocates for Nursing Home Reform provide many excellent resources for individuals and families making the tough choices about custodial care, including an evaluation checklist for those considering residential care:

Review Complaint and Inspection Information: The local office of the California Department of Social Services will have information about the latest government inspection and complaint investigations. Unlike skilled nursing facilities, residential care facilities are only inspected every five years so the information may not be fresh. Pay particular attention to any violations of resident's rights or abuse allegations.

Visit the Facility: Go visit and tour the assisted living home. Is it clean? Do the residents appear well cared for? Ask if there is a written care plan for every resident, and don't be afraid to strike up a conversation with another resident or a visiting family member.

Look at More than One: You want to make the most informed decision you can about the home, and that requires some perspective. Visit as many residential care facilities as you can before deciding (even if you really liked the first one you visited).

To read CANHR's complete report on how to evaluate residential care facilities for the elderly click here.

The attorneys at Walton Law Firm represent the victims of abuse are neglect in the nursing home, residential care, and assisted living 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.

California law allows the creation of "family councils" by relative of a nursing home resident to help influence the quality of care given to a resident. Not merely gripe sessions, these councils can facilitate communications between families and residents with the nursing home staff and caregivers, and also offer peer support for friends and relatives of the resident, and help prevent substandard care.

A nursing home may not prohibit the formation of a family council, and must allow the council to meet on the grounds of the facility at least once a month. In addition the home must designate a staff member who is responsible for assisting the council, and to respond to all written requests made by the council.

The California Advocates for Nursing Home Reform provides excellent resources for the creation and maintenance of a family council, and advice as to how the make the council an effective tool to promote high quality care. (Click here to access the CANHR site)

CANHR also provides an excellent video about family councils, and how they can make a big difference:

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

The California Advocates for Nursing Home Reform (CANHR), a statewide advocacy organization dedicated to improving care for California seniors, has launched a weekly radio program for seniors. The show is called Elder Issues and Answers, and his hosted by Pat McGinnis and Prescott Cole. The show airs Saturday mornings at 9:30 am, can be heard online at KTRB860.com. (Click here to listen)

McGinnis and Cole are leaders with CANHR, and are experts in the areas of elder care. Upcoming shows will feature guests, and will cover such topics as trust mills, nursing home abuse and neglect, financial elder abuse, reverse mortgages, resident's rights, and Medi-Cal Recovery. Tune in.

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.

Many nursing homes are now marketing themselves as “rehabilitation” facilities in an effort to attract the ideal resident: one who stays under 100 days then goes elsewhere. Why? Because Medicare provides lucrative fees for skilled nursing care. It is not uncommon for nursing homes to discharge residents, often prematurely, when the Medicare benefits end.

Most people are unaware that when Medicare coverage ends, a resident who needs skilled nursing care has a right to stay, either by paying privately, or qualifying for Medi-Cal coverage. Under Welfare and Institutions Code section 14124.7, no nursing home that accepts Medi-Cal payments can evict, or transfer within a facility, any person who changes the manner of paying from private or Medicare to Medi-Cal.

For more information on discharge and transfer rights in California nursing homes, see the fact sheet provided by California Advocates for Nursing Home Reform.

The San Diego elder abuse lawyers at Walton Law Firm LLP represent individuals and families throughout Southern California in cases of nursing home abuse and neglect. All consultations about a case are free and confidential.

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.

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.

We are frequently asked how nursing home neglect or abuse can be prevented. There is no magic answer, but there are things one can do to lessen the odds that a loved one will be subject to physical neglect, financial abuse, or suffer the decline in health caused by poor care. The California Advocates for Nursing Home Reform have published a guide for preventing abuse in long-term care facilities. How does one increase the odds there will be no abuse or neglect?

1. Be very supportive of the transfer to a nursing home. Under most circumstances, the initial entrance to a nursing facility will engender feelings of loss or abandonment. Visit frequently to help with the adjustment.

2. Make the most of visits. Visit frequently, and at different times. Also visit during meal time. This will give you a more complete picture of care and the performance of staff.

3. Get to know the staff. Building personal relationships with the caregivers can be an excellent way to ensure good care.

4. Participate in care planning meeting. No one knows your family member better than you. The care plan meeting will give you an opportunity to alter the course of treatment to meet the needs of your loved one.

5. Be an advocate! Do not be afraid to advocate for the rights of your loved one. All residents have basic rights (click here) and you need to fight for them without fear of retaliation.

Don’t try to do this all alone. Enlist other family members and friends to help, and communicate often. Most nursing homes can provide good care; it’s just a matter of making it happen.

The law firm of Walton Law Firm LLP is based in Southern California, and represents individuals impacted by neglect and abuse in the nursing home and residential care setting. 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.

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.

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).

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

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

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

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

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 quality of care provided by California nursing homes has declined by almost every measure since the implementation of a new Medi-Cal rate system that increased funding the nursing facilities according to a new study by the University of California, San Francisco (UCSF). Meanwhile, nursing home complaints and the issuance of deficiencies have grown dramatically since the rate hike.

Critics contend that the nursing home industry crafted the rate hike on the basis that it was necessary to improve care. And while staffing levels improved under the new law, nursing home staff turnovers increased. The study reveals that 144 nursing homes in California failed to meet state minimum staffing requirements (.pdf).

According to the California Advocates for Nursing Home Reform:

The rate system's most controversial provision is a profit component that pays nursing homes 8 percent of their labor costs to spend or pocket as they wish. Estimated to cost Medi-Cal and taxpayers about $150 million per year, it is deceptively labeled as a "labor driven operating allocation." Every freestanding skilled nursing facility certified by Medi-Cal receives profit payments, no matter how poor its care. No other Medi-Cal providers are guaranteed a profit.

The entire UCSF study can be found here (.pdf). If you have any questions about nursing home quality of care, call Walton Law Firm LLP at (866) 607-1325.

Budget cuts proposed by Governor Schwarzenegger could cripple California's oversight of Residential Care Facilities for the Elderly. Further damage to the already struggling oversight program could put thousands of RCFE residents at risk.

According the California Advocates for Nursing Home Reform (CANHR), the proposed cuts come at a time when assisted living care is growing at a rapid rate. There are more than 7,000 assisted living facilities in the state, an increase of more than 25% over the last decade. Current law requires an inspection of RCFEs only once every five years, a dramatic decline from the 1980s when such facilities were subject to inspections twice a year.

Inspecting RCFEs once every five years or less is a recipe for neglect and abuse," said Patricia McGinnis, CANHR’s executive director. "Care standards and residents’ rights become virtually meaningless when inspections are so rare. Issuing a license under these conditions deceives consumers who assume the state is conducting regular inspections or offering oversight and protection to residents.

In my practice, I have seen more and more RCFEs retaining residents that should be moved to a higher level of care, but are retained in the assisted living facility for questionable reasons. This trend, combined with an unthreatening state oversight program is not good news for California seniors.

The Nursing Home Complaint Investigation Improvement Act (AB 399), authored was approved last week in the Assembly Health Committee by a vote of 10-0. The legislation would fight abuse and neglect by improving the quality and timeliness of nursing home complaint investigations. AB 399 has over 30 registered supporters including the AARP, Congress of California Seniors, Gray Panthers, and Bet Tzedek Legal Services. There is no registered opposition.

According to the California Chronicle, AB 399 would require the Department of Health Services (DHS) to complete investigations within 40 working days; send complainants a written summary of findings about their complaint; investigate facility-reported complaints of abuse and neglect within the same time frames as public complaints; and extend the number of days a complainant has to seek an informal conference from five business days to 15 days after receipt of the determination.

"Today's vote is an important step toward restoring public confidence in California's nursing home oversight system," said Michael Connors of California Advocates for Nursing Home Reform (CANHR). "Timely DHS investigations will help ensure that nursing home residents are protected from further neglect and abuse once it's been reported."

Supporters of the law are urged to write Governor Schwarzenegger as soon as possible and urge him to sign AB 399 into law.

The California Advocates for Nursing Home Reform (CANHR) in San Francisco has been fighting for the rights of long-term nursing home residents for more than 20 years. Through community education, legislation and litigation, it has been CANHR's goal to remind decision makers of what needs to be done about long-term care; that this "forgotten population" consists of our mothers and fathers, our husbands and wives, our brothers and sisters, and that their suffering is our shame. CANHR has received numerous awards for its work.

Walton Law Firm is proud to support the work of CANHR, and is now participating in its 2007 Campaign for Justice, an effort to continue the great work of this valuable organization. If you are interested in providing your support to the cause, and helping to give a voice to the voiceless, please visit our contribution site and contribute. Any contribution you can make will be appreciated.

Thank you.

Randy / Scott / Kim