Articles Posted in California Department of Public Health

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Earlier this month, the Sacramento Bee ran a story that exposed the lack of oversight from the California Department of Public Health (CDPH) when it comes to nursing home abuse allegations. What is going on? According to the article, the CDPH is “weighed down by a backlog of more than 11,000 open complaints” with “no clear path to dig its way out.”

Evidence of this serious problem became cID-10045437lear after an audit report was released toward the end of October 2014. In short, the CDPH appears to have failed elderly adults in nursing homes and assisted-living facilities by failing to manage its investigations of elder abuse complaints received.

Numerous Problems “Up and Down the State”

While the Sacramento Bee was among the first newspapers to run the story about the recent CDPH audit, the report makes clear that the investigation problems exist far beyond northern California. Indeed, from San Diego up through Mendocino County, it looks as if the CDPH has not taken proper care with the elder abuse complaints it has received. To be sure, the audit showed that, “up and down the state,” a number of different district offices “were found to be inconsistent and haphazard in their handling of complaints, investigations, and corrective action plans.”

The report showed that department officials readily acknowledged the problems the CDPH has had with regard to investigating complaints, and many of those officially actually agreed with recommendations that came out of the audit. However, the CDPH has shown tremendous resistance when it comes to establishing a time frame for completing the investigation of a complaint. The CDPH indicated that it “recognizes the importance of timeliness,” but it rejected the notion of setting a specific time limit for investigation on each complaint.

Serious Problems that Were Not Investigated

The backlog of complaints—those cases that are still open—involve allegations of elder abuse that could have very serious repercussions. As the article emphasizes, many of these complaints are “not trivial.” Indeed, the auditor discovered that “40 percent of the unresolved concerns and allegations had been given high priority by the department,” which means that “the reported problem had caused or was likely to cause harm to a resident.”

For example, the Sacramento Bee described one case of elder abuse that was reported in April 2012. According to the auditor’s report, the state of California failed to even assign anyone to investigate the complaint until August 13, which was nearly a year and a half after the incident. By that time, the injured resident had left the nursing home, and the certified nurse assistant who had been implicated in the abuse got away with a mere warning. And this case represented a “high-priority” case for the CDPH.

Lower priority cases went unresolved for particularly long periods. The audit suggests that, for those cases not marked as high priority, the average time between complaint and investigation was about 3,500 days on average—or, in other words, ten years.

If you suspect that your elderly parent has been the victim of elder abuse at a long-term care facility in California, it is extremely important that you contact an experienced San Diego nursing home abuse lawyer.

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Have you been urged to place your elderly parent in hospice care despite the fact that he or she is not terminally ill? Hospice care is intended for patients who are terminally ill and for whom there is no cure. So why are healthy older adults ending up in hospice? A recent article in the Washington Post revealed that this phenomenon might be a larger problem than we’d like to think. Indeed, over the 2000s, the newspaper reported that the “number of ‘hospice survivors’ in the United States has risen dramatically.” What’s going on? According to the article, “hospice companies earn more by recruiting patients who aren’t actually dying,” since “healthier patients are more profitable because they require fewer visits and stay enrolled longer.”

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If you have been pressured to move a parent into hospice care, your elderly loved one might not receive the kind of treatment she or he needs. For-profit companies shouldn’t be allowed to take advantage of older adults. Indeed, we might think of these actions as another form of elder abuse. It’s important to speak to an experienced elder law attorney about your options.
Hospice Discharge Statistics
According to the Washington Post, more patients than ever are being discharged from hospice care centers—something that was never intended to happen based on the primary tenets of hospice care. In fact, the number of patients who have been discharged over the past decade has risen substantially. Between 2002 and 2012, “the proportion of patients who were discharged alive from hospice care rose about 50 percent,” based on an analysis conducted by the newspaper.

For example, at AseraCare, one of the largest hospice chains in America, “about 78 percent of patients who enrolled at the Mobile, Alabama branch left the hospice’s care alive,” while “as many as 59 percent of patients left the AseraCare branch in nearby Foley, Alabama alive.”

That investigation relied on records from more than one million hospice patients in California over the past decade. According to the article, California is a good source for information about hospice care and discharge rates. The state keeps detailed records that are readily available to the public, but since the state is so large, it also “offers a portrait of the industry.”

Over the past decade as discharge rates rose, so did the average length of a patient’s stay in hospice care. As a result, hospice centers earned significantly more profits. In fact, based on records from California, “profit per patient quintupled, to $1,975.” And much of those funds came from Medicare. Is the government paying money it doesn’t need to provide to for-profit hospice care companies?

The For-Profit Hospice Industry and Patient Harms
As hospice has become a multi-billion for-profit industry, hospice “recruiting” has become a money-making tool, and it’s putting a heavy burden on Medicare. According to the Washington Post, about $15 billion of hospice industry revenue came directly from Medicare in 2012. That’s a huge percentage of the industry’s profit. And that percentage only seems to be rising, according to research undertaken by MedPAC, the government Medicare watchdog group.

There are more serious problems than the drain on Medicare, as well. Former hospice workers have alleged that hospice patients don’t receive the care they need when they’re not terminally ill. The Justice Department “joined several of these lawsuits,” according to the article. In short, hospice companies make more money when they have patients, regardless of whether those patients are terminally ill. Yet, many of those patients suffer in the long run—they don’t receive proper care for non-terminal illnesses since they’re assumed to be dying.

If you have been pressured to place your elderly loved one in hospice care, you should speak to an experienced nursing home abuse lawyer today. At the Walton Law Firm, we want to put an end to the overuse and misuse of hospice care. Contact us today to discuss your case.

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Earlier this month, Johnson & Johnson agreed to pay a settlement of more than $2.2 billion connected to “accusations that it improperly promoted the antipsychotic drug Risperdal to older adults,” according to a recent article in the New York Times. This resolution actually represents the third-largest pharmaceutical settlement in our country, and it’s one of the largest agreements in “a string of recent cases involving the marketing of antipsychotic and antiseizure drugs to older dementia patients.” The federal government is working to ensure that pharmaceutical companies are held liable for bad drugs and bad marketing.

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This news is only the latest in many reports concerning elderly dementia patients and the varied problems of antipsychotic drugs. Indeed, the California Department of Public Health and the Department of Health Care Services have been working to reduce the “off-label” use of antipsychotic medications in nursing homes and assisted-living facilities across the state. Experienced California elder justice advocates have been handling cases involving the use of antipsychotic medications, and the dedicated lawyers at the Walton Law Firm can discuss your claim with you today.
What is Risperdal?
The $2.2 billion settlement involves claims associated with Johnson & Johnson’s marketing of Risperdal and other antipsychotic drugs, in particular the promotion of “off-label” use of these drugs and “payment of kickbacks to physicians and to the nation’s largest long-term care pharmacy provider,” according to the new release from the Department of Justice. Some of the bad marketing extended to the use of antipsychotic medications for dementia patients. Other drugs involved in the settlement include Invega and Natrecor. But what are these drugs, and how have they been dangerous to elderly consumers?
Risperdal is a brand name for the drug risperidone, according to the Mayo Clinic, and it’s a drug that’s typically used to treat schizophrenia, bipolar mania, and autism. Invega is also an atypical antipsychotic drug that’s a brand name for paliperidone. As you might have heard, nursing homes and assisted-living facilities have been reported to make “off-label” use of these medications for treating elderly patients with dementia. When a drug is used “off-label,” it simply means that it’s being used for a different purpose than what the FDA has approved. When antipsychotic medications are used to treat dementia patients, the drugs can have serious side effects. Moreover, they’re often not the best first course for treating symptoms of Alzheimer’s and other forms of dementia, according to the Alzheimer’s Society. In short, there are other methods for managing the behavior of older adults with dementia, and most commentators agree that antipsychotic drugs aren’t the answer.

Details of the Johnson & Johnson Settlement

According to the language of the settlement, Johnson & Johnson’s illegal off-label marketing of antipsychotic medications began in 1999 and extended through 2005. Eric H. Holder Jr., the United States attorney general, emphasized that Johnson & Johnson’s bad drug-promotion practices “recklessly put at risk the health of some of the most vulnerable members of our society—including young children, the elderly and the disabled.” In fact, many commentators believe the off-label use of antipsychotic medications to treat dementia patients constitutes nursing home abuse.

Under the terms of the settlement, Johnson & Johnson will also enter a guilty plea for a criminal misdemeanor, admitting that it “improperly marketed Risperdal to older adults for unapproved uses.” According to federal officials, Johnson & Johnson “actively pursued the market for geriatric patients” even when Risperdal wasn’t approved for such a use.

If your elderly loved one has suffered from nursing home abuse or neglect, it’s important to speak to an experienced California nursing home abuse attorney as soon as possible. Contact us today.

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“I could not protect the public any longer. There was just a failure to protect the most vulnerable people in our state from abuse and neglect” said (former) investigator for the California Department of Public Health (DPH) investigator Marc Parker of his retirement from the agency that is supposed to certify and regulate California’s nursing homes.

KQED and the Center for Investigative Reporting has an excellent article out today about the failures on the part of the state to investigate and prosecute allegations of neglect and abuse in thousands of California nursing facilities.

DPH.jpgThose of us who prosecute civil cases on behalf of these victims – or, sadly, their heirs – have been experiencing this for years. We all have had cases where the DPH letter arrives saying that the complaint “could not be substantiated” despite overwhelming evidence of wrongdoing. Or the investigator finds some small (and usually irrelevant) “deficiency” when ask to investigate a clearly suspicious death. Or telling the victim’s families to be patient, but knowing full well that the likely hood of a citation against the home, even in the strong cases, was highly unlikely.

We always suspected that DPH was full of overworked, burdened bureaucrats who worked by the saying “Hear no evil, see no evil, and speak no evil…so I don’t have to write a long evil report.” Now there is evidence to support that claim.

The Center for Investigative Reporting has uncovered documents showing that DPH investigators repeated delayed and ignored investigations into nursing home complaints for months and months, and in some cases years. In one profiled case involving the death of an 95-year-old woman, the family and ER nurses suspected abuse, but DPH didn’t complete its investigation for over six years, and even then took no action. Thankfully, law enforcement has opened an investigation.

“I would tell anybody, do not count on the government taking care of you,” said Brian Woods, in charge of DPH’s Southern California office in 2006. “They are overworked. They can’t get in there. Your case might get looked at 10 years later.” Incredibly, from the years 2004 through 2008, DPH had a backlog of over 900 complaints alleging abuse or neglect, many involving a death.

To deal with the backlog, the article asserts, investigators are being told to close files, even if inadequate investigations have been conducted. Many times the investigator doesn’t even visit the facility or talk to witnesses.

Criminal prosecutions are also becoming rare. According to the article, from 2006 through 2009, DPH referred 88 deaths to the Attorney General’s office for prosecution. In 2011, there were only two deaths referred.

This makes little sense to San Diego District Attorney Paul Greenwood.

“I don’t know how many nursing homes there are in California or how many deaths a year there are in the facilities, but the number is going to be huge,” Greenwood said. “And to think there are only two suspicious deaths? No, I just frankly cannot believe that.”

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Nor can we at Walton Law Firm.

KQED and the Center for Investigative Reporting has provided an invaluable public service in this investigative report, which hopefully will lead to better awareness to the problem, and a fix to the problem.

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Earlier this month, the California Department of Public Health fined a Sacramento nursing home for the choking death of a patient. The nursing home received an $80,000 fine after Mary Yip, an 86-year-old patient with swallowing difficulties, “choked on a piece of meat during a lunchtime outing with staff members,” according to the Sacramento Bee.

Choking deaths are very serious violations for which many nursing facilities in our state have been fined. Just a few months ago, we told you about a San Diego care center that received a $100,000 fine from the State of California. Nursing homes in Los Angeles County and Orange County have also been fined for choking deaths. If your elderly loved one has experienced nursing home abuse or neglect, it’s important to speak to an experienced nursing home abuse attorney as soon as possible.

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Details of the Serious Violation

In addition to having swallowing difficulties, Yip also suffered from dementia and disability following a stroke. She resided at the Asian Community Center nursing home in Sacramento. While surrounded by staff, Yip choked to death in January 2012. The incident came to the attention of the California Department of Public Health (CDPH) after the nonprofit Foundation Aiding the Elderly (FATE) filed a complaint against the Asian Community Center nursing home “at the request of Yip’s family.”

According to the report released earlier this month, investigators with the CDPH discovered that staff members served Yip a lunch of noodles with chunks of meat. The report emphasized that “they failed to supervise her while she ate, despite a physician’s directive that she was unable to chew and should eat only soft foods.” According to FATE founder Carole Herman, Yip “was very compromised by her illnesses and needed 24-hour care.”

In total, five patients had been on the outing. Three staff members and a volunteer accompanied them. When Yip started to choke, a staff member did perform the Heimlich maneuver in an attempt “to dislodge the food in her throat,” but these efforts failed. The staff members called emergency medical services, but Yip had already gone into cardiac arrest when the paramedics arrived on the scene.

Physicians later removed “a large piece of what appeared to be meat” from Yip’s throat, but she never regained consciousness and passed away the following day.

After substantiating FATE’s complaint against the Asian Community Center nursing home, the CDPH assessed the facility with “its most severe penalty, a Class AA citation,” which accompanied an $80,000 fine. This facility actually has a good track record prior to this serious citation, according to Herman. In fact, Herman emphasized that “it’s one of the better facilities” in the area, “based on the lack of complaints.”

Choking Problems and the Elderly

Only four nursing facilities in Sacramento County have received class AA citations. Yet, choking problems are a serious concern for elderly residents at nursing homes. According to the National Safety Council, elderly persons are at a greater risk for choking while they’re eating. In fact, choking is the third leading cause of home injury death for adults over the age of 76. These accidents tend to peak around age 85, but then choking is the second leading cause of accidental death in adults aged 89 and older.

Many older adults should be supervised while they’re eating, and nursing homes have a duty to care for the elderly patients in their facilities. If your elderly loved one has experienced a choking incident at a nursing home or has been a victim of nursing home negligence, don’t hesitate to contact us today.

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San Diego Care Center Cited for Patient’s Choking Death

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The California Department of Public Health (CDPH) cited the San Diego care facility Villa Rancho Bernardo Care Center (Center) for inadequate elder care, which resulted in the death of one of its residents. According to a story from NBC San Diego, the Center received the most severe penalty under state law, a “AA” citation that is accompanied by a $100,000 fine from the State of California. This isn’t the first time the Center has been cited by the CDPH. In fact, a previous citation occurred only a few years ago. Is this care center safe for patients?

What Led to the Recent Citation?
The Center had specific physician’s orders for a 61-year-old dementia patient’s diet. The patient had been admitted to the facility with a diagnosis of dementia, and his physician’s orders later stated that he had cognitive/behavior impairment (or decreased mental status).

As a result of his diagnosis, the patient required a “special chopped diet” that entailed having his food cut into very small pieces every day. According to a healthcare services manual, a “mechanical chopped diet” such as this one requires that meats be chopped “to the consistency of small dice,” or approximately ½ inch. This special diet had been prescribed because the patient had exhibited past behaviors in which he’d grab food and immediately stuff it into his mouth.

On October 31, 2012, the staff at the Center failed to have the patient’s food chopped, and the patient was served two pancakes and two uncut sausages. The patient proceeded to put all four of these food items into his mouth, and he then choked and died. The CDPH report described the Center’s negligence as the “direct proximate cause of the death of the patient.”
How Did This Happen?
According to the report, a series of people failed to notice the dietary error including: the cook, the dietary line checker, the licensed nurse, and the certified nursing assistant. None of these staff members verified “that the prescribed diet, in the correct consistency, was checked prior to bringing the meal tray into [the patient’s] room.”

The incident violated the Center’s policy on “Choking Prevention,” which states that, prior to serving meal trays to its residents, the licensed nurse assigned to the dining room is required to check that each meal matches the “diet slip” provided by each resident’s physician. Then, the Certified Nursing Assistant (CNA) is required to “double check” the tray after the licensed nurse checks it. The CNA does this in order to check “for any missed items or wrong diet” that the licensed nurse may have overlooked.

While the report doesn’t indicate how the licensed nurse and the CNA both failed to identify the problem with the resident’s meal, the CDPH is holding the Center accountable. And this isn’t the only case in which the Center has failed to provide adequate care.

History of “AA” Citations at the Center

In February 2010, less than three years before the choking death of the patient discussed above, the Center received another “AA” citation and $100,000 fine for the death of another dementia patient, who also suffered from psychosis. According to that report, the resident “sustained fatal head injuries after falling down a concrete stairwell” outside the Center. The resident, who was confined to a wheelchair, opened an emergency door and “fell down 20 concrete steps” while he was “still restrained in his wheelchair.” At the time of the fall, he was completely unsupervised. He died two days later from the injuries he sustained during the fall.

If you have an elderly loved one who has sustained injuries due to nursing home neglect, an experienced attorney can discuss your case with you. Contact us today.

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A skilled nursing facility in Montrose was indicted for criminal abuse and neglect after a committed suicide by discharging a fire extinguisher down his throat. A grand jury indictment asserts that the facility, Wellness Centre, and its former administrator were complicit in the death of 34-year-old patient Charles Morrill. It was the third time Morrill attempted suicide.

“On and between January 22, 2009 and February 28, in the County of Los Angeles, the said Verdugo Valley Skilled Nursing Wellness Center and Phyllis Paver did, under circumstances and conditions likely to produce great bodily hard and death, knowingly and willfully cause and permit Charles Morrill, a dependent adult, to suffer, and inflicted theron, unjustifiable physical pain and mental suffering and, having the care and custody of said person, willfully caused and permitted him to be placed in a situation in which his health was endangered, and knew and reasonably should have known that said person, Charles Morrill, was a dependent adult.”

The indictment came after an investigation by the California Department of Public Health, which had a long history with the facility. Glendale Police told reporters that over the last few years it had received numerous calls about residents wandering away from the facility, 911 hang ups, and accusations of assaults at the nursing home.

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The Goldstar Rehabilitation and Nursing Center was issued an AA citation by the California Department of Public Health after investigators concluded that substandard care led to the choking death of one of its residents. According to reports, the 60-year-old resident, who was on a doctor-ordered soft diet, died after choking on solid food during dinner. The man choked for 10 -15 minutes before passing out. Nursing staff was unable to revive him.

The Department of Public Health has the statutory authority to levy fines against nursing facilities for acts of abuse, neglect, or otherwise substandard care. State citations imposed are categorized as Class B, A or AA, depending on the severity of the wrongdoing. The fines range from $100 to $1,000 for Class B up to $100,000 for Class AA. The citation class and amount of the fine depend upon the significance and severity of the established violation.

READ THE COMPLETE CITATION BY CLICKING HERE

Source: Los Angeles Times

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults and their families in cases involving abuse, neglect, or malpractice in the nursing home. Call (866) 607-1325 or complete on online for a free and confidential consultation.

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California Assembly Bill 313 would require nursing homes and residential care facilities to notify all residents and family members if the license of the facility is in jeopardy of being revoked. The bill, authored by Assemblyman Bill Monning, would require written notification “when its license is in jeopardy from serious deficiencies, revocation or suspension, or court proceedings.” The bill was instigated by events at a Santa Cruz nursing home were residents and those responsible for them were not given adequate notification before the license was revoked.

Source: theCalifornian.com

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

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The California Department of Public Health issued its most severe citation to a California nursing home following the death of a 97-year-old resident. According to reports, the Gramercy Court nursing home patient fell out of her bed and onto the floor while a nursing assistant had her back to the patient. The resident suffered a spinal injury and died a short time later.

State investigators said the fall could have been prevented if the bed rail, which was ordered, had been in place. As a result, a AA citation was issued against the facility, and a $90,000 fine assessed. The maximum fine allowable under California law is $100,000.

To read the entire AA citation, CLICK HERE (.pdf).

Source: Sacramento Bee

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. Any unexpected injury, illness, infection, or death may be the result of abuse or neglect. Call (866) 607-1325 for a free and confidential case evaluation.