California Nursing Home Abuse Lawyer Blog

According to a recent report by All Voices, understaffing is a prevalent problem in local nursing homes. Our San Diego nursing home abuse attorneys know that understaffing at California nursing homes is a serious issue because it has consistently been shown to lead to increased instances of elder abuse or neglect. For example, at facilities where there is understaffing, caretakers may become frustrated and impatient with residents who need extra care and attention. When nursing home employees are overworked due to understaffing, residents often face a higher risk of injuries—e.g. from wandering or falls—due to inadequate supervision.

The latest report listed California as one of the states with the highest rate of elder abuse. Approximately 33% of nursing homes have been reported for abuse. According to the report, 89% of those abused in nursing homes never report their abuse. Tragically, per the reasonable standards laid out by a variety of organization, a tragic 90% of nursing homes do not have adequate staffing. Clearly, it is a problem that can have serious implications for California nursing home residents and their loved ones. Specifically, understaffing can lead to many significant problems, including: low staff to patient ratios, under training, high levels of staff stress and burnout, high staff turnover, false charting, and under- or over-medication.

According to the Center for Disease Control’s 2004 report on nursing homes, the current nursing staff to patient ratio is 1 nursing staff member for every 1.64 residents. Low staff-to-patient ratios mean that employees must undertake too many tasks, so there is not enough time for staff members to spend adequate time with residents. The result is that the amount of time recommended per day for staff to spend with residents is not being met. For example, the federal government suggests that staff members should spend 3.45 hours per day with a resident. Nursing home experts recommend even more face time with staff at 4 hours per day. The U.S. Department of Health and Human Services recently proposed requiring nursing home aides to spend a minimum of 2 hours per day with each resident, but 53% of nursing homes presently do not meet this standard.

Another serious effect of understaffing is that nursing home staff may be undertrained. Since staff-to-patient ratios are often so low, employees are frequently faced with completing tasks that they have not been trained to perform. Our San Diego elder abuse lawyers previously explained that facilities where staff members feel supported and well trained also report better rates of satisfaction from their residents. When understaffing occurs, however, nursing home employees usually experience high levels of stress and burnout, which frequently leads to high rates of staff turnover. Staff turnover disrupts patient care and also contributes to the problem of inadequate training. If staff members are stressed out and burnt out, they can lose compassion and respect for their residents, which can lead to California elder abuse.

Continue reading "Understaffing Cited as a Major Source of California Nursing Home Abuse" »

Our San Diego nursing home abuse lawyers know that both federal and state law guarantee elderly patients certain rights and protections, including the right to adequate medical treatment and care, as well as the right to be treated with dignity and respect. Those protections include the right to be free from physical or chemical restraints that nursing home staff may wrongfully use to control or discipline patients.

On the other hand, some unscrupulous staff members may deny elderly residents treatment or take medications from their patients. According to the Atlanta Journal Constitution, a forty-year-old registered nurse, Amy M. Armstrong, was recently caught stealing pills from an elderly hospice patient. The nurse was employed by a hospice agency to provide care for the patient in the patient’s home. A family member of the victim suspected that the nurse was stealing the medication and alerted police. Police set up video cameras in the victim’s home so they could catch the nurse in the act.

While police watched, the nurse removed the victim’s narcotic painkillers from the victim’s home. When officers moved in to arrest the nurse, they discovered the narcotic painkillers and anti-depressants on the nurse’s person. The nurse was charged with two counts of felony theft by taking, two counts of California elder abuse, and two counts of possession of controlled substances. She is currently being held on bond.

Thanks to the diligence of the police and the elderly patient’s family member, this negligent caretaker was caught red handed. Unfortunately, abusers often target the most vulnerable members of our elderly population. In this case, the nurse—who had been hired to provide care and comfort—was stealing the medication necessary to ease the pain of an elderly hospice patient. As a result, the nurse faces both criminal and civil sanctions.

In other instances, San Diego negligent nursing homes may overuse medication to manage “hard-to-control” patients, particularly those with dementia. This type of elder abuse is often referred to as using medication as a chemical restraint. Caregivers may attempt to take the easy way out instead of providing each patient with the attention and individualized treatment he or she deserves. Family members should be aware of important warning signs such as if your loved ones are unusually lethargic or disoriented for no reason. They could also appear confused at times or extremely forgetful.

If you suspect that a loved one is being abused in any way, one way to help stop abuse in its tracks is to check in on your loved ones frequently. Calling or visiting elderly relatives or friends can alert family and friends to the signs of abuse. Family members should feel free to check in with their loved ones’ doctors or caretakers and to either support their loved ones as they voice complaints or concerns about care or raise such concerns themselves. Many facilities permit and encourage residents or family members to recommend changes in policies or services to facility staff.

If your concerns go unaddressed, family members should not hesitate to report abuse. Reporting elder abuse is essential to preventing the abuse from escalating. Our San Diego elder abuse attorneys know how to walk you through the process and how to help you protect your loved ones.

See Our Related Blog Posts:

California Nursing Home Neglect Caused By Chemical Restraints

Elder Abuse Lawsuit After Abuse Caught on Video

One of the main challenges faced by victims of San Diego nursing home abuse is the difficulty in identifying and documenting specific instances of poor care. Many area nursing home residents do not understand their right to receive proper care or recognize when they have received substandard treatment. Even when they are aware of negligence by employees, many seniors and their families are unsure what they should do to document the problem.

Documentation is often important in these matters, because judges, juries, and state regulatory bodies often rely on a paper trail to understand the sort of care that a resident received. Unfortunately, there remain lax standards when it comes to keeping track of reports of San Diego nursing home neglect. The problem exists throughout the state as facilities in all corners of California are currently not required to document when a resident or family member files a complaint suggesting substandard treatment.

One local advocate is seeking to change that, and is urging that the state pass legislation which would force nursing homes to keep track of neglect and abuse charges. The North Country Times reported on the legislative push last month. The effort is being spearheaded by Lynda Tammone, an area resident who became frustrated after her husband received substandard treatment while spending a year in a nearby nursing home following sudden health problems.

A former emergency medical technician, Mrs. Tammone carefully documented the care her husband received while at the facility. She found at least 27 separate instances of mistreatment including staff member’s failure to act on low blood sugar levels, failure to assess skin tears and abrasions, and failure to document skin problems on weekly reports. She eventually sent a letter to the California Department of Public Health explaining the problem. While the state department ultimately substantiated some of those claims, many other were deemed unsubstantiated because of documentation deficiencies.

State inspectors explained that many allegations cannot be proven if they are not mentioned in a patient’s medical record. Therefore, if a facility fails to keep proper medical records of health problems or care complaints, then many genuine claims will go uncorrected by state officials. This apparent loophole is what is spurring Mrs. Tammone to seek legislative changes in the hopes of catching more instances of California nursing home neglect.

The bill likely faces strong opposition in the state legislature as large nursing home interests are likely to vehemently oppose efforts to keep track of care complaints. If these logs were kept, then elder care advocates would be able to more clearly show how a facility had notice of a certain problem and then failed to take corrective action.

Our San Diego nursing home neglect lawyer is well versed in the way that proper documentation is used to provide justice to families harmed by nursing home abuse and neglect. One of the main ways that an attorney aids in these situations is by understanding what facts are relevant in the legal system and knowing how such facts can be proven to a judge or jury. In the nursing home context, this includes recognizing the records that help prove a claim and identifying where evidence of poor treatment can be found. If you or a loved one may have been injured because of poor care, please visit a legal professional to learn how the truth about the treatment can be uncovered and reported.

See Our Related Blog Posts:

California Elder Abuse Typically Goes Unreported

Los Angeles County Nursing Home Fined After Choking Death

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.

Continue reading "Glendale Nursing Home Criminally Indicted After Patient Death" »

Attorney Randy Walton was invited by the Intertribal Court of Southern California to speak on the issue of elder abuse and nursing home abuse and neglect. The event took place on June 15, 2011 and was hosted by the San Pasqual Band of Indians. Approximately 100 people attended.

The event was entitled Know Your Rights, Benefits & Laws, and was produced to benefit tribal elders and seniors from all the San Diego County Indian tribes. Topics included Identity Theft, Medicare, Elder Abuse, Health and Well Being, and Social Security Benefits, and included a variety of speakers.

Mr. Walton addressed the issue of abuse and neglect in the custodial care setting, including nursing homes and assisted living facilities, and advised what to do to avoid abuse and neglect, and what to do if it occurs.

The Walton Law Firm provides free consultations to individuals and families throughout Southern California who believe a loved one has been neglected in the hospital, 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.

Law enforcement officers from the California Department of Justice arrested a San Jose nursing home employee on suspicion of elder abuse after it was learned the employee, according to new accounts, "yanked on the elderly man's genitalia." Two other employees were arrested for knowing about the abuse, and failing to report it. The three face misdemeanor charges of elder abuse and battery and failing to report.

According to a press release from the CDO, agents from the Bureau of Medi-Cal Fraud and Elder Abuse received a report about "sexual misconduct" at the Idylwood Care Center. The report came from the California Department of Public Health in January after it received a tip from an anonymous source that certified nursing assistant Arnold Sampson was witnessed grabbing the testicles of a male resident and making crude comments. A criminal investigation was then commenced.

The investigation revealed that Sampson had abuse the resident on other occasions, and had threatened to continue to touch him to "torment him."

A spokesman for the nursing home issued a statement saying that, "Idylwood has always placed the highest priority on ensuring the most responsible level of care for our residents. We have cooperated fully with the attorney general in this investigation and will continue to do so."

Continue reading "Nursing Home Caregiver Arrested for Sexual Assault of Resident" »

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.

The online magazine Long-Term Living has compiled a list of persons it has determined as the "most influential" in the long-term care industry. It prefaces its list with a kind of warning that the industry has a storied history "full of ups, downs, hair-raising regulation and heartwarming innovations." The magazine doesn’t identify the "downs" or the "hair-raising regulations," but a clue might be a name included on short list (that also includes the late Edward Kennedy).

The magazine has listed James L. Wilkes, II of the law firm Wilkes & McHugh, P.A. to the list of most influential persons in the long-term care industry. Based in Florida, Mr. Wilkes is a nationally recognized attorney who, like the Walton Law Firm, represents individuals and families who have been impacted by nursing home neglect, a far too common occurrence in American nursing homes. Mr. Wilkes is described as a "holy terror" to nursing homes, because of the lawsuits he files against them for "negligent resident care, often manifested by life-threatening pressure ulcers, falls, fractures, and assaults due primarily to alleged understaffing by large for-profit chains."

Congratulations to Ms. Wilkes for his inclusion on this list, and for fighting the fight on behalf of abused and neglected nursing home residents everywhere.

Source: Long-Term Living

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.

An elder abuse and neglect lawsuit has been filed on behalf of an elderly Korean-American woman who died last year after what the family alleges was abusive treatment by her caregivers. Kyong-hui Duncan died last June while her family was looking for a new nursing home to take her to after it became concerned about the care she was receiving.

When the family's concerns began, Ms. Duncan's grandson installed a security camera in her room. The camera wasn't hidden, and caregivers knew about its presence, but family members became suspicious when they would frequently find the camera turned off when they came for visits.

Though the family claims the camera was often shut off by care providers during routine visits, images taken by the camera during one such visit show caregivers violently shaking Duncan as they attempt to place her in a wheelchair. The family adds that she would often be seen sitting in her room for hours, crying for help, sometimes upside down in her wheelchair, without any response from the attendants at the center. Bruises were also periodically found on her body, while an autopsy revealed toxins from medicines not prescribed by her doctors.

SEE THE VIDEO HERE

Reports from the Los Angeles office of Adult Protective Services, the incidence of elder abuse among elderly Koreans is on the rise. The report states that many Koreans are reluctant to seek help out of fear of humiliation and shame. In the Duncan case, the owners of the home have denied all wrongdoing.

Source: BayCitizen.org

The nursing home abuse and elder neglect attorneys 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 hospital, 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.

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.

The giant nursing home neglect verdicts continue to come in around the country. Last week, a jury in Kentucky awarded the family of a neglected nursing home resident $42.75 million after the resident became lethally dehydrated and malnourished, and arrived at the hospital covered in bed sores. The resident died as a result.

According to news accounts, 92-year-old Joseph Offut had been a resident of Harborside nursing home for only nine days prior to his death. The World War II veteran had been very active up until the age of 90, when he suffered a stroke and was cared for by his wife of 58 years. Like many, after some difficult conversations the family ultimately decided that Mr. Offut needed professional care and placed him in a nursing home.

After his death, Offutt's family filed a lawsuit for wrongful death against the nursing home's parent company, Sunbridge Healthcare Corp. The lawsuit alleged that caregivers at the nursing home neglect Offut, causing him to suffer severe dehydration, malnutrition, decubitus ulcers, and ultimately death.

The trial lasted three weeks. The jury returned a verdict in favor of the family and awarded $1 million for Mr. Offutt's pain and suffering, $1.75 million for his wife's loss of consortium, and $40 million for punitive damages.

Source: Kentucky.com

The Southern California nursing home elder 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, 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.

It is being reported by California Watch that the U.S. Department of Justice is investigation what is being described as lax care at several California nursing homes, and even threatening criminal and civil actions against those homes. Specifically, the investigators will be examining the use of psychotropic drugs in these facilities and those injured by the misuse of such drugs. Also being investigated are the nursing homes that prematurely discharge patients whose condition requires them to stay.

The investigation was triggered in part by the federal health reform law that includes the Elder Justice Act. That act allows for the coordination between the U.S. attorney general's office and local and state law enforcement to crack down on elder abuse and neglect. The Northern California office of the Justice Department retained the services of a consultant, who interviewed local ombudsmen’s offices about nursing home complaints. Out of those interviews, several facilities were identified.

U.S. Attorney Melinda Haag told California Watch that her office hired the consultant approximately two months ago, shortly after a California Watch article about the decline in the prosecution of elder abuse cases. “My office is in the process of evaluating the complaints our consultant gathered and will prosecute, to the fullest extent of the law, those individuals who are in violation of federal statutes," Haag said in a written statement.

Source: California Watch

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, assisted living, board and care, or home health care setting. Call (760) 571-5500 for a free and confidential case evaluation.

This story makes one wonder what would happen if a hidden camera sting was done in every nursing home. The attorney general of New York placed a hidden camera in a single room of a long-term care facility, which resulted in an indictment against nine nurses, the nursing home, for a whopping 169 separate crimes.

The indictment filed in the case alleges 57 instances of neglect during a three-month period in 2009. With the family's permission, a hidden camera was placed in the room of a 53-year-old resident who suffers from multiple sclerosis and other mental and physical illnesses. The video revealed that the nurses failed, on several occasions, to turn the patient regularly as required, failed to medicate as needed, treat his pressure ulcers, or even change the resident's clothing. Of course, in the medical chart, these nurses stated that all this care had been provided. The fraudulent medical charting resulted in further criminal charges.

In interesting footnote to the story, when the alleged abuse revealed, several people came to The Record newspaper to tell their stories of abuse or neglect inside the facility, including unanswered call lights and untreated infections and bed sores.

While this story came from New York, we have had cases involving every single allegation made in this story, and can (unfortunately) say with some confidence this type of treatment occurs at facilities throughout California.

Source: The Record

The San Diego nursing home abuse and neglect lawyers at Walton Law Firm provide free consultations to individuals and families who believe a loved one has been a victim of neglect in the nursing home or assisted living setting. Call (760) 571-5500 or (866) 607-1325 for a free and confidential case evaluation.

There has been a string of large verdicts against nursing homes for poor care. A few months ago, a Northern California jury returned a verdict of over $600 million against a nursing home chain for deliberately understaffing its homes and putting residents at risk. Two weeks ago an Orange County jury awarded $3.1 million in a case involving a morphine overdose. And last week, a Georgia jury awarded $43 million in a wrongful death lawsuit, believed to be the largest in the state's history against a nursing home.

In the Georgia case, the surviving family members of 80-year-old Morris Ellison sued after their father died after a stay at the Moran Lake Nursing Home. Mr. Ellison fell numerous times in the home, including one fall that broke his hip. According to reports, the nursing home failed to notify doctors when Mr. Ellison suffered his fracture.

The nursing home was operated by a company called the Forum Group Corp., which was owned by attorney George Houser. Houser represented himself and the nursing home during the trial, and, of course, lost big. But after the verdict, things only got worse for Houser. Immediately after the verdict was rendered, Houser was arrested and taken into custody for contempt of court.

Life got even worse for Houser when and his wife were both indicted for bilking Medicare and Medicaid programs out of more than $30 million. According to the federal indictment, Houser funnel money into personal accounts that were supposed to go toward care to residents at his three nursing homes. While residents suffered, Houser and his wife purchase luxury cars and real estate, including a $1.3 million Atlanta home. Dirtbag.

"Mr. Houser, through his companies, systematically drained the money and resources from his nursing homes [and] caused all sorts of shortages of food, water and medicine and basic supplies," said Stephen G. Lowry, a plaintiff attorney. "He was severely neglected at the time of his death, malnourished and severely dehydrated."

At the trial, a nursing home director testified the facility lacked the funds to pay its staff or even pay bills.

Source: The Atlanta Journal-Constitution

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. Call (866) 607-1325 for a free and confidential case evaluation.

The AP has a story out today about the Skilled Healthcare Group verdict in Northern California, where a Humboldt jury awarded a class of plaintiffs $677 million dollars for what it determined was chronic and deliberate pattern of understaffing at its nursing homes that left elderly residents at risk of harm. The jury found that Skilled Healthcare regularly violated state regulations requiring it to keep a minimum number of nurses on duty at its 22 homes in the state.

One witness in the case recalled visiting her father, who had Alzheimer's disease, and frequently finding him lying in urine-soaked sheets. She said it would routinely take up to 20 minutes for someone to respond to a call light.

"The major problem for most nursing homes in California and in the nation is staffing," Pat McGinnis, executive director and founder of the California Advocates for Nursing Home Reform, told the AP.

The article notes that Wall Street investment firms bought several nursing home chains in the early 2000's, and, critics charge, went on to drastically reduce staffing levels. (For example) Skilled Healthcare, a public company, saw its stock value plunge as a result of the verdict, and now others wonder if their next. Many of the country's 16,000 nursing homes are owned by publicly traded companies.

To read the entire AP article click here.

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

A resident of St. Edna skilled nursing facility in Santa Ana (a Covenant Care facility) was awarded $3.1 million by an Orange County after the jury found that the nursing home failed to recognize that the resident was overdosing on morphine. The jury also found that the nursing home acted with malice or oppression, and will award punitive damages at a hearing next Tuesday.

St. Edna's was among the many California nursing homes who received $880 million in Medi-Cal compensation from the state in a program that began in 2004, and was designed to promote care and avoid staffing deficiencies. Many homes that received the additional money still reduced staffing, despite profiting from the additional funds. Apparently St. Ednas was one of those homes.

In this case, Barbara Lefforge was admitted to St. Edna on Sept. 17, 2007, to rehabilitate from tendon repair surgery. Her surgeon mistakenly recommended 50 mg of morphine for pain instead of 50 mg of Demerol. That is a huge dose of morphine, which Lefforge's attorney argued should have been promptly caught by the nursing home staff. According to reports, a nurse at the facility could not get the full does, so took 30 mg from an office emergency kit and gave it to Lefforge, who suffered an overdose, which itself went unnoticed by the staff. She suffered a major brain injury.

“I feel this is a just result and fair based upon the conduct that St. Edna’s staff engaged in,” attorney Ted Wacker told the Orange County Register.

After deliberating for two days, the jury found St. Edna 90 percent at fault for the damages, and the surgeon who wrote the wrong prescription only 10 percent at fault. Jurors awarded $2 million for pain and suffering and $1.1 million in medical costs.

Source: Orange County Register

The Southern California 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. Call (866) 607-1325 for a free and confidential case evaluation.

It was announced this morning that six nursing home workers were arrested for playing a cruel prank on several residents at the Valley View Skilled Nursing Facility. According to a release from the California Attorney General's office, the employees applied a slippery ointment cream over the bodies of seven elderly nursing home residents to make them "slippery" for the oncoming shift. It is believed that the residents were selected because all suffered from advanced dementia, and could not object to the mistreatment.

"As part of a cruel and shocking prank, these caregivers abused defenseless elders," AG Jerry Brown said. "This is despicable behavior by people placed in a position of trust."

After an investigation by the California Bureau of Elder Abuse, the district attorney's office has filed a misdemeanor criminal charge against each employee for injury to elder or dependent adult; battery committed on elder or a dependent adult; conspiracy; and battery committed while on hospital property.

Attorney General Brown's Bureau of Medi-Cal Fraud and Elder Abuse was created to protect elderly patients from physical and financial abuse and neglect in long-term care facilities, as well as home health care. In 2009, the bureau obtained convictions in 49 criminal cases of elder abuse.

Source: Imperial Valley News

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and disabled and dependent adults 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.

San Diego's 10News I-Team has conducted an investigation into what it is calling the chemical restraint of elderly residents of nursing homes. That is, using anti-psychotic drugs not necessarily for their prescribed use, but to control behavior in residents who otherwise wouldn't be candidates for the drugs.

The investigation profiles the family of Dr. Keith Blair, a retired dentist, who died at age 86 after a stay at Arbor Hills Nursing Center in La Mesa. The family contends Dr. Blair's death was expedited by the use of the anti-psychotic drugs Risperdal and Haldol that were given without consent. Both drugs contain warnings that state the drugs are "associated with an increased risk of mortality in elderly patients."

Upon one visit to the nursing home to see her father, Marian Hollingsworth told the I-Team that her father was "completely out of it. I shook him on the bed, I hollered his name. I asked the nurse what was going on. I couldn't wake him up. She said, 'Oh, he was sleepy last night.'"

After her father' died, a review of his medical records showed that staff at both the hospitals and the nursing home gave him Risperdal and Haldol without consent. The family has filed a complaint with the California Department of Public Health.

The use of anti-psychotic drugs in the elderly for behavior control is a growing concern among advocates for the elderly. The California Advocates for Nursing Home Reform will be launching a website on this topic alone, and Dr. David Graham, a Food and Drug Administration expert, recently told Congress that the practice of drugging the elderly to control them results in at least 15,000 deaths annually.

A video of the I-Team story can be found by CLICKING HERE

Source: 10News.com

The San Diego 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. Call (760) 571-5500 for a free and confidential case evaluation.

A jury has awarded the family of a 76-year-old nursing home resident $114 million for egregious nursing home abuse and neglect. The family's lawsuit against the nursing home alleged that the staff knew Juanita Jackson was at a high risk for falls but failed to take preventative measures. She fell within two weeks of admission and suffered a closed head trauma and fractured her upper arm, injuries from which she never fully recovered. The family also alleged that Integrated Health Services, the nursing home where Ms. Jackson lived, failed to provide the elder woman adequate care, including allowing her to become malnourished and dehydrated.

The verdict may not be all that it's cracked up to be. According to news accounts, the nursing home quit defending itself in the lawsuit several weeks ago after many years of litigation, and the family was able to get a default judgment. The judge then asked the jury to determine the proper amount of damages. After some deliberation, the jury awarded $14 million in compensatory damages, and $100 million in punitive damages. The nursing home, of course, was not there to defend itself.

The family intends to do everything it can to collect on the judgment, and told the TheLedger.com that it was proud of itself for standing up for their mother.

Source: TheLedger.com

The Riverside County nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and disabled and dependent adults 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.

Johnnie Esco, age 77, was hospitalized because of pneumonia, and her husband of 61 years was at her bedside every day. When she recovered, she was sent to a local nursing home for physical therapy, to help her regain her strength, and then she was headed home, where she wanted to be. That day would never come.

After only two weeks in the nursing home, Johnnie's health had deteriorated to the point that she needed an emergency transport to the hospital, where she died a short time later. Her family was stunned, and now believes that the nursing home's failure to provide adequate care caused Johnnie's death.

"If she had received proper care, she would still be alive today," Johnnie's husband Don told KCRA news.

Don hired elder abuse attorney Leslie Clement, who filed a lawsuit against the nursing facility, alleging elder neglect and wrongful death, contending that the nursing home simply warehoused Johnnie. A major theme of the lawsuit is the nursing home's failure to provide basic custodial care because of a lack of staffing. In depositions, caregivers essentially testified that the facility was understaffed, by stating that they asked for help (more staff), or that they were required to care for a very large amount of patients (Watch the VIDEO HERE to see their compelling testimony).

Source: KCRA.com

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

"Elvis impersonator Donald Trapani is about to leave the building. But not just yet." So begins an article in yesterday Arizona Republic paper about hospice patient Donald Trapani, who spends his days entertaining his fellow hospice patients with his impersonation of Elvis Presley. What a nice story.

READ THE ENTIRE ARTICLE BY CLICKING HERE.

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and disabled and dependent adults 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.

Disability Rights California, a non-profit that advocates for the rights of the disabled, recently released a report finding that the physical abuse of disabled adults in nursing homes are frequently not treated as crimes. The study analyzed 12 cases, including the following

• For months, a middle aged nursing home resident suffering from cerebral palsy with cognitive impairment was paraded naked and soaking wet in front of others after being forced by staff to take cold showers. Despite many witnesses, nothing was done.

• A disabled resident in his 40s was punched in the mouth by a staff member and then slapped, drawing blood. When he complained, it took days for the facility to report it to authorities. No charges were brought.

• An activity assistant in a nursing facility pushed two elderly residents in wheelchairs down the hall, causing them to slam into each other. When they stopped, they were left stranded.

• While assisting a disabled female resident with a bath, a male caregiver fondled her breasts. Despite complaining to the nursing home administrator, the facility assigned the aide to the same resident. The aid criticized the resident for telling on him.

Overall, Disability Rights California investigated the stories of nine men and seven women, age 41 to 97 years old, with physical, mental and cognitive disabilities, that were physically or sexually abused by nursing home staff. The physical abuse ranged from assault and battery, to sexual assaults, including allegations of rape.

“This is just the tip of the iceberg of hundreds of confirmed cases of nursing home resident abuse we see every year from Department of Public Health citation reports,” stated Leslie Morrison, one of the authors of the report. Experts estimate that for every case of abuse that is reported, as many five go unreported.

Incredibly, state and law enforcement investigators concluded that the reported incidents (half were never even reported) were not criminal, and were handled as employee concerns. In most of the cases, the only punishment was deficiencies or a small citation from the California Department of Public Health.

To read the entire report, entitled “Victimized Twice: Abuse of Nursing Home Residents, No Criminal Accountability for Perpetrators," click here. [.pdf]

Source: DisabilityRightsCA.org

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and disabled and dependent adults 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.

Closing arguments began in what is now one of the longest trials in Humboldt County history involving allegations of neglect at 21 nursing homes owned by Skilled Healthcare. Michael Thamer, a lawyer dedicated to defending the rights of nursing home residents, will argue that Skilled Healthcare, because of deliberate decisions to keep nursing home staff at the lowest possible numbers, repeatedly exposed its residents to substandard care, including the failure to regularly bathe its patients, allowing residents to lie in soiled bed sheets for hours, and failing to treat bed sores.

”In my opinion, they (staff members) are set up to fail before they even start,” Thamer told the court.

Under California law, nursing must provide at least 3.2 hours of nursing care per resident, per day. These hourly requirements apply to direct patient care, and must be performed by registered nurses, licensed vocational nurses and certified nursing assistants. According to the plaintiff, Skilled Healthcare totally failed in this regard, and regularly understaffed its facilities for financial gain.

”We are trying to send this corporation a message,” said Michael Crowley, Thamer's co-counsel. “They need to care more about their patients and less about their bottom profit line.”

More than 32,000 people are represented in the class action, and, depending how the court decides to calculate the statutory penalties, Skilled Healthcare could be liable for up to 1.4 million violations to the tune of $2,500 each.

Source: Times Standard

The Southern California 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. Call (866) 607-1325 for a free and confidential case evaluation.

A nursing home caregiver is being charged with second degree murder after the death of an Alzheimer's patient in a North Carolina nursing home. Authorities believe that caregiver Angela Almore deliberately administered large quantities of morphine to 84-year-old patient Rachel Holliday in order to make her "more manageable." It is believed that other residents were also given the drug for this purpose, and cite six other Alzheimer's patients who required hospitalization while under the care of Almore.

The arrest and indictment of Almore stems from an investigation by Medicaid Investigations, who launched an investigation after nine of 25 patients in the nursing home's Alzheimer’s wing at the nursing home tested positive for opiates. Sadly the use of opiates and other psychotropic drugs to control patient behavior is an ongoing problem at nursing homes across the country. Here at Walton Law Firm we have had several cases involving the improper use of medications, which exposes nursing home residents to untold number of dangers, including overdose, falls, or simply a loss of dignity.

Almore's next court date is set for July 13.

Source: CBSnews.com and charlotte.news14.com (with video)

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

This is an amazing story. A nursing home video camera catches a nursing caregiver deliberately dump an 85-year-old resident out of her wheelchair and onto the floor, and then simply walk away. In the horrific video, Nurse Jesse Joiner walks over the wheelchair, and abruptly jerks it to the left, causing the frail woman to fall hard on the floor. Incredibly, Joiner simply walks away as the woman is writhing on the floor. As if that weren't stunning enough, minutes later another caregiver notices the woman on the floor, and does nothing for more than a minute. According to the new story, the victim fractured her hip in the fall. Her current condition is unknown.

As a firm that has handled numerous fall-fracture cases in the nursing home, including several that were supposedly "accidental falls" from a wheelchair, it is stunning to see this. You can bet that the nursing notes say that the resident fell on her own, and that she had some propensity to try to get out of her wheelchair. What's also interesting is that the nursing home looks like a pretty nice place in the video, and according to the story has a clean record with state authorities.

As we always say, any unexpected injury, illness, or death should be examined. Also, you can never the judge the quality of a home by how it looks on the outside or inside. How many times have other residents at this home been injured or killed by incidents that were noted to be simple accidents.

CLICK HERE TO WATCH THE VIDEO

Source: WBCBSTV.com

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

A Sacramento jury slammed an area nursing home with a $28 million verdict last week after it found the home liable for elder abuse and neglect. Before deliberations, attorney Ed Dudensing told the jury to, "make them feel it." It did. The nursing home, as expected, will appeal.

What is believed to be the largest verdict of its kind, the jury hoped to send a message that if you’re going to run a nursing home, you better do it in a way that doesn't jeopardize the health and welfare of its residents.

The jury came back with the huge punitive damages award the day after it found that the corporation Horizon West Healthcare and its nursing homes Colonial Healthcare committed elder abuse upon 79-year-old Frances Tanner. Tanner, a government worker who at one time worked for the FBI and Internal Revenue Service, was admitted into Colonial in March of 2005. After suffering a fall that went undiagnosed for days, she died seven months later for an infected bed sore.

Colonial Healthcare had a history of problems with regulators, and had been cited in the past for poor care. Tanner's death resulted in its fourth citation in recent years. Dudensing contended that Horizon Healthcare was deliberately understaffed, which resulted in inadequate care and monitoring, leaving its residents, including Tanner, exposed to harm.

Source: Sacramento Bee

The San Diego elder 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.

An elderly man with Alzheimer's disease died as a result of a nursing home's negligent care according to a report released by the California Department of Public Health. According to the investigation findings, the nursing home resident also was noted to have dysphasia, or difficulty swallowing. While being fed by a certified nursing assistant, the man began to cough and gasp for air. Though in obvious distress, no telephone call to emergency response was made for 20 minutes (something caregivers lied about to DPH). When paramedics arrived approximately 10 minutes later, the man was already dead.

The DPH issued a AA citation and an $80,000 fine for its failures.

The nursing home, Homewood Care Center in San Jose, was owned by Jack Easterday. Mr. Easterday was sentenced to 2 1/2 years in prison in 2007 for his willful failure to pay employment taxes. He was the owner of a company called Westline Medical Management, which owned Homewood Care Center and several other nursing homes in California.

Source: MercuryNews.com

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 California legislature has called for an investigation into why only one-third of the fines assessed against nursing homes for negligent care are being collected. The audit that was approved in February is expected to look how the funds are collected and how they're spent.

Mike Feuer, D-Los Angeles told California Watch, “The whole point of having citation accounts and the penalty system is to deter nursing homes from doing anything but provide the highest quality care to residents. If the fines coming in are less than a third of (those) issued, it leaves one to wonder if the state is being as effective as it could be in protecting nursing home residents.”

Records obtained by California Watch reveal that in 2008 state regulators collected only $1.5 million of the $5 million that had been assessed against California skilled nursing facilities. In comparison, the same regulators have collected nearly 80 percent of the fines levied against hospitals. Kathleen Billingsley, the deputy director of the Department of Public Health Center for Healthcare Quality, said nursing homes who appeal fines do not have to pay until the process is completed.

And while nursing homes continue to appeal more and more citations, they also appear to be getting steep discounts. Take the case of Casa Bonita Convalescent Hospital. The facility had been warned about turning off ventilator alarms, but ignored those warnings and allowed a 90-year-old resident died after her ventilator became disconnected and the alarm did not engage. The facility was assessed a $320,000 fine, but after appeals was only required to pay $20,000.

To read California Watch's full nursing home story package, which includes graphics, click here.

The nursing home negligence 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. Call (866) 607-1325 for a free and confidential consultation.

California Watch is out with a disturbing report alleging that California nursing homes that received more than $880 million in additional taxpayer funds under a law designed to boost care, took the money did the opposite by cutting staff and wages. ["Nursing homes received millions while cutting staff, wages"] In its investigation, California Watch found 232 California nursing homes that either cut staffing, or paid lower wages to workers after receiving money from the state.

It appears that many of the nursing homes investigated used the state money to improve their financial health, not the health of its residents, and those that cut the most staff had, not surprisingly, more deficiencies issued by state inspectors than those facilities that did not cut staff.

“There was an implicit good faith agreement that things would get better … and that was broken,” state Sen. Elaine Alquist, D-Santa Clara, told California Watch. “It was broken for the people of California and for a very vulnerable population – those that need the greatest care and those that can’t advocate for themselves.”

Orange County nursing home company Covenant Care gets special attention. The Covenant Care-owned nursing facilities cut caregivers even though the company received $15 million in additional funding. The average profit a Covenant Care facility was more than $900,000 in 1998, which was three times higher than the other 632 nursing homes evaluated by California Watch.

In addition, the state money has apparently had no impact on the rate at which complaints are made about nursing home care. The California Department of Public Health documented approximately 1,000 deficiencies issued against California nursing homes in 1998, which was a 65 percent increase over 2005, when the additional funding began.

To read the entire California Watch article click here.

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

It took jurors only five hours to convict 21-year-old Cesar Ulloa of criminal elder abuse for his brutal treatment of residents at the Calabasas nursing home where he worked. According to prosecutors, Ulloa would laugh as he attacked his victims, many of whom were to demented to be able to call for help. He faces life in prison.

In one of the assaults, a fellow employee witnessed Ulloa jump on the chest of a non-verbal 78-year-old woman's chest, and throwing her on the bed as she struggled. To another elderly male resident, Ulloa jumped off a dresser and landed with both knees on the man's abdomen, seriously injuring the man. He apparently would laugh with delight while brutalizing the patients.

Suspicion over Ulloa actions was raised after the wife of a resident received an anonymous phone call the day after her husband's funeral. The call said that her husband had been abused, and that his death may have been related to the abuse, something the family suspected. The police were notified, and the victim's body exhumed for an autopsy that revealed more than 24 fractures. The man's death was determined to be caused by blunt force trauma.

According to the L.A. Times, when the widow testified at trial, jurors, and even the court reporter cried.

The case was especially shocking because the facility, Silverado Senior Living, was considered a high-end nursing home. But any nursing home neglect and abuse lawyer will tell you that the way the facility looks, or the price, is rarely an indicator of quality of care. In fact, prosecutors in the Ulloa cases argued that Silverado (like most facilities) are vulnerable to abuse because "caregivers there... generally take the floor with little more than a high school education and just a few days of training."

Source: Los Angeles Times

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

The healthcare reform bill signed by President Obama this week will have an impact on nursing homes and long-term care. The most dramatic change will come in the form of long-term care insurance, and provision that was long championed by the Senator Edward Kennedy. Under the Community Living Assistance Services and Support Act (CLASS), all Americans will automatically be enrolled in a long-term care insurance program, but will have the option to opt out.

Under the Act, individuals will start paying a premium immediately, and will be able to use the benefit after five years of contribution to the program. The benefit, though, is not much, as it is expected to be about $50 per day to offset other long-term care costs.

The healthcare reform bill will also start to close the "donut hole" in Medicare Part D coverage for prescription drugs. Patients will immediately begin receiving a rebate for drug costs that fall into the gap, and drug manufacturers will be required to provide a discount on brand name drugs. Over time, the gap in coverage will be phased out entirely.

The Nursing Home Transparency and Improvement Act is also part of the bill, and will require nursing homes to provide consumers with more information about nursing homes and the quality of care they provide. It will also provide better weapons for enforcing quality standards in nursing facility, and encourage homes to improve on their own. AARP has called the transparency bill "one of the most significant nursing home reform initiatives" in two decades.

Finally, the bill contains the Patient Safety and Abuse Prevention Act, which will create a national system of background checks, to keep nursing home workers with criminal histories out of the long-term care setting.

Sources: SeniorJournal.com and HealthLeadersMedia.com.

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 skilled nursing facility, residential care facility for the elderly, and assisted living setting. Call (760) 571-5500 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.

A 76-year-old patient at the Ridgecrest Nursing and Rehabilitation Center in DeLand died after falling to the floor and lying there for 12 hours. Barbara Fasold fell out of her bed at approximately 5:00 a.m. and a fractured both legs and her shoulder, and was not discovered on the floor until a shift change at nearly 5:00 p.m. later that day. When discovered, Ms. Fasold was rushed to a local hospital, but was so badly injured in her fall that she died less than a week later.

It is estimated that a nursing home with an average of 100 beds will experience between 100 and 200 falls every year. More concerning is that nearly 2,000 nursing home residents will every year from injuries related to a fall, and fall victims who survive often suffer debilitating injuries.

Nursing homes are required to prevent falls by providing adequate care-planning. Not all falls can be prevented, but if the nursing facility does an adequate job of assessing the risk of falling on a patient-by-patient basis, and then provide regular reassessments and interventions on an ongoing basis, particularly after a fall, many more falls would be prevented.

The attorneys at Walton Law Firm represent seniors and dependent adults throughout California who have been injured or neglect in the nursing home and assisted living 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 their ongoing series on nursing oversight in the State of California, Tracy Weber and Charles Ornstein of ProPublica are out with another story about California's shortcomings in regulating healthcare professionals. Weber and Ornstein reveal that the national database that tracks dangerous or incompetent caregivers is missing serious disciplinary actions against "what are probably thousands" of health care providers. The revelations apparently surprised federal health officials, who just last month proclaimed that "no data is missing."

For almost twenty years the federal government has kept a database of disciplinary actions against doctors and dentist, and in 1999 individual state boards were required to include in the database reports on all other healthcare professional, including nurses, whose licenses were restricted or revoked. In California, however, not all penalized caregivers were included in the federal database. For example, California has formally disciplined 84 psychiatric technicians over the last two years, yet the federal database does not contain a single report of discipline against a psychiatric technician in the State of California.

The dangers of an incomplete database are obvious, as Dr. Sidney M. Wolfe of the Public Citizen's Health Research Group observed, prospective employers of health care professions could be given "a false sense of security that somebody who may be really dangerous isn't, because their name isn't there."

To read the entire ProPublica article click here.

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 skilled nursing facility, residential care facility for the elderly, and assisted living setting. Call (760) 571-5500 for a free and confidential consultation.

The nursing home roommate from hell. A former San Diego nursing home resident was sentenced to 19 years in jail yesterday for setting a series of fires at two local nursing homes while she was a resident. According to an investigation, Mary Wilson tried to kill her nursing home roommate by setting her bed on fire while she slept. In another incident, Wilson threatened a resident with a knife.

The first incident occurred in January of 2009, when Wilson was a resident of the San Diego skilled nursing facility El Dorado Care Center in El Cajon. She was placed in a room with two roommates, both of whom were on oxygen and confined to their beds. In the middle of the night, Wilson got out of her bed and set the mattress on fire of one of her roommates. The fire alarm was triggered, and caregivers were able to extinguish the flame before any injuries occurred.

In May, Wilson was transferred to the assisted living center Golden Paradise Senior Living in National City. Shortly after her arrival, she set fire to trash cans and in the library. Luckily, there were no injuries.

Prior to yesterday's sentencing, Wilson pled guilty to two counts of attempted murder, three counts of arson, and one count of assault with a deadly weapon. Attorney General Jerry Brown lauded the prosecution and sentencing.

"These fires were no accident," Brown said. "This woman meant to kill or seriously injure dozens of disabled people. Residents of nursing homes are particularly vulnerable, so today's sentence is an important victory in our fight against elder abuse in California communities."

Source: SanDiego6.com

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 skilled nursing facility, residential care facility for the elderly, and assisted living setting. Call (760) 571-5500 for a free and confidential consultation.

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

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

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

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

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

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

A few times a year we hear news stories of Alzheimer's sufferers wandering away from their homes and becoming lost. Those stories end one of two ways, and unfortunately, too often the ending is not a happy one.

These sad stories have created a cottage industry for nursing home providers. We have all now heard of nursing homes advertising themselves with "special neighborhoods for the memory impaired." Or providing "safe and secure" housing for the Alzheimer's patient. But what happens when the victim wanders away from those facilities?

A few years ago, such a thing happened in Escondido. Then a 94-year-old woman walked out of Palomar Heights Care Center in Escondido and into the path of a car, killing her instantly. Caregivers told the media that they didn't know what happened, but a subsequent lawsuit revealed some serious neglect on the part of the home.

It happened again yesterday in Castro Valley. An 89-year-old Alzheimer's sufferer was killed by a car after wandering away from an "Alzheimer's & Dementia Care Facility." It's unclear how this incident occurred, but you can bet that the primary reason the family of the victim placed him in the facility was to prevent the very thing that took his life. An investigation into the accident is ongoing.

Source: Mercury News

The nursing home abuse and neglect attorneys 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.

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.

U.S. News and World Report, famous for its "best" lists, is out with a ranking of the country's best nursing homes. There are approximately 16,000 individuals living in U.S. nursing homes, and approximately 3.2 million will spend time in one each year. Here at Walton Law Firm we get asked all the time to recommend nursing homes, but rarely can provide a good answer. In our experience, the best guarantor of good care is an attentive family who visits frequently.

Here is a list of the top 25 Southern California nursing homes as ranked as the U.S. News and World Report ranks as the best:

1. Rady Children's Hospital Bernardo Center, San Diego
2. Community Care Center, Duarte
3. Green Acres Lodge, Rosemead
4. Harbor View Center, Long Beach
5. Hillcrest Manor Sanitarium, National City
6. Parkside Special Care Center, El Cajon
7. Providence St. Elizabeth Care, North Hollywood
8. Whittier Hospital Medical Center, Whittier
9. Windsor Manor, Glendale
10. All Saints Healthcare Sub-acute, North Hollywood
11. Artesia Christian Home, Inc., Artesia
12. Bear Valley Community Hospital, Big Bear Lake
13. Brotman Medical Center, Culver City
14. California Convalescent Center, Los Angeles
15. Cherrylee Lodge, El Monte
16. Clear View Sanitarium, Gardena
17. Community Convalescent Center of San Bernardino, San Bernardino
18. Country Villa Broadway Healthcare Center, San Gabriel
19. Country Villa Glendale Healthcare Center, Glendale
20. Dunlap Sanitarium, Los Angeles
21. Glenbrook at La Costa Glen, Carlsbad
22. Kearny Mesa Convalescent, San Diego
23. Lanterman Developmental Center, Pomona
24. Marguerite Gardens, Alhambra
25. Monterey Care, Rosemead

To read the complete list click here.

The list was compiled by a variety of measurements, including state inspections, nursing home staffing, and other quality measures under Medicare and Medicaid guidelines. As mentioned in U.S. News, the "grade" is just that, a grade. It doesn't mean that your experience at this home will be of the quality suggested. There is no substitute for an in-depth visit to the nursing home you choose, which should include speaking with other residents and their families.

Source: U.S. News and World Report

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.

According to new research from Brown University, elderly Hispanics are more likely to live in inferior nursing homes than their white counterparts.

In an article out in the January 10 edition of Health Affairs, a team of researchers takes the first comprehensive look at the types of nursing facilities Hispanic elderly live in, and how the care at those homes compares to homes that house a primarily white patient population. According to the study, the disparity is sharp.

"The most shocking finding is the pervasiveness of disparities in nursing home care that are primarily white, compared to nursing homes that are a mix of whites and Hispanic residences," said Mary Fennell, professor of sociology and community health at Brown.

According to Fennell, the study reflects a change in elder care among Hispanic families, which traditionally has used nursing homes less than white or black families. In Hispanic households, care of the elderly is usually provided by adult daughters. But the economic realities of 21st Century America are changing that. Fennell said that the loss of in-home caregivers is occurring as the growth of elderly Hispanics is rising dramatically.

The study found that nursing home residents are increasingly coming from the lower end of the socio-economic scale, and lacking resources for better quality care in assisted living facilities or elsewhere. "People with resources can get into very good places or alternatives for nursing home care," Fennell said. "Everyone else is left with not-very-good facilities that are not performing well."

Source: Brown University

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.

A certified nursing assistant working in a San Diego nursing home is being held on charges of rape and elder abuse after being caught having sex with a nursing home resident. According to reports, an employee of the El Dorado Care Center in El Cajon walked into the room of an elderly patient and saw Felix Panem sexually assaulting the patient. Panem is being held on $450,000 bail, and faces a possible 10 year sentence if convicted.

Sexual assault in the nursing home is not common, but it is certainly not rare. Because of age and infirmity, including memory problems such as dementia and Alzheimer's disease, nursing home residents can be fairly easy targets for the criminally inclined. The Walton Law Firm has has cases involving sexual assault, physical abuse, and burglary committed by employee caregivers. Sometimes it's just a rouge employee, but there are times when the facilities fail to perform adequate background checks that would have revealed the criminal propensity of a caregiver.

Investigators told the Union Tribune that they believe that the elderly resident is Panem's only victim, but believe that she may have been raped by him on other occasions. The El Dorado Care Center is a skilled-nursing facility on Washington Street in El Cajon, California.

Source: signonsandiego.com

The San Diego 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. Call (760) 571-5500 for a free and confidential consultation, of fill out an online form.

We blogged earlier about the $7.75 million dollar verdict a 71-year-old stroke victim was awarded after she proved to a civil jury that she was abused by caregivers in her nursing home. The lady's family decided to place a hidden camera near the bed of Maria Arellano, and caught some ghastly footage of an attendant pulling the elderly woman's hair, bending her fingers and neck, and treating her violently in the shower. Now, as expected, the defendant, Fillmore Convalescent Center, plans on appealing the verdict.

It's attorney Thomas Beach told the Ventura County Star, “We strongly disagree with the decision and will be taking all appropriate legal steps to set aside the verdict.” Strongly disagree? Of course he disagrees; he told the jury to give her nothing.

What makes this case most interesting is that the plaintiff attorney Greg Johnson made a settlement demand of $500,000 long before the trial. He had compelling video, and a great story, and not only did the nursing home ignore his demand, they never offered him a penny.

If Mr. Beach's post-trial statements are any indication of how this will play out, it's not going to be pretty. He states that the family knew of the abuse a year earlier, but didn't report it. He is now "concerned" as to why it was not reported. Maybe this is a new (risky) theory - blame the family - but if he had such concerns, why didn't he raise them at trial?

The jury has spoken. The elder abuse victim should be paid.

Source: vcstar.com

The elder 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.

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 their ongoing investigation into California nursing, Tracy Weber and Charles Ornstein of ProPublica are out with an article on temporary nursing agencies being a haven for unfit nurses. Temp nursing agencies are used frequently by local hospitals and nursing homes to fill nursing positions that have been vacated for some reason; usually for day or two, but sometimes open-ended.

In its investigation, ProPublica found numerous instances in which the agencies, desperate to find certified nurses, failed to perform background checks or ignored warnings from hospitals about weak nurses in order to fill nursing orders. It is a profitable undertaking; the temporary nursing industry is a $4 billion industry.

Some of the other ProPublica findings were startling:

- Temp firms hired nurses who had criminal records or left states where their licenses had been restricted or revoked. At least temporary nursing agencies employed a nurse in California whose license had been suspended in Minnesota for stealing drugs at a string of temp jobs. One used him after he'd been convicted of doing the same thing at a Santa Rosa nursing home.

- Nursing agencies shuffled errant nurses from one hospital to another, even as complaints mounted. A Culver City agency continued sending one nurse to hospitals despite more than a dozen warnings that she was ignoring her patients and sleeping on the job. Before she was hired, the nurse had been convicted of 12 crimes, including prostitution, carrying a concealed weapon and possessing cocaine.

- Nurses who got in trouble at one agency had no problem landing a job at another. An Oklahoma nurse cycled through at least four Southern California agencies in a year, accused of pilfering drugs while at each.

Sadly, there are a ton of temporary nurses out their practicing nursing in local hospitals and nursing homes. We see it all the time in our nursing home abuse and neglect law practice. In fact, we've had cases against nursing homes that only used temp labor. According to the report, almost 6% of registered nurses in California (approximately 19,300) are temporary nurses.

Here's a scary example: Nurse Beverley Cathey had trouble in her home state of North Carolina. She decided to move to California in July 2007 for better nursing opportunities. She applied for a job at EZ Staffing in Glendale, told them she had experience in critical care, and the next day she was working at Huntington Memorial Hospital. After a series of nursing mistakes - she had six complaints against her by the end of August - EZ Staffing to check her nursing license in North Carolina. It turns out she was on probation.

Read the full L.A. Times article here for more scary examples.

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.

The State of California has announced that healthcare providers, namely nurses, that have abused drugs will face more stringent guidelines to maintain their licenses. After treatment, the nurses will be required to pay for regular drug testing. After a negative test, the nurse will be able to return to work, but during the first year, will be required to undergo 104 drug tests. The new guidelines state that a single failure of a drug test will result in an immediate suspension of the nursing license. In addition, the state will be permitted to publically identify nurses who are being subject to this increased supervision.

These new regulations follow an L.A. Times investigation earlier this year (and blogged about here) that found several problems in the licensing, certification, and regulation of California nurses. In that investigation, it was revealed that numerous nurses with documented drug problems were allowed to continue working without consequence, and that nursing complaints were taking years to resolve.

The new regulations can be found here.

Source: McKnight's

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.

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.

George Washington once said:

Discipline is the soul of an army. It makes small numbers formidable; procures success to the weak, and esteem to all.

Letter of Instructions to the Captains of the Virginia Regiments [July 29, 1759]. The advocates of consumer rights, viewing the resources of defense firms and corporate defendants, can relate to the trepidation felt by the out-numbered and out-gunned Continental Army. Because of that disparity in resources, Consumer Attorneys of California ("CAOC") consolidates the voices of consumer attorneys throughout the state to (1) preserve and protect the constitutional right to trial by jury for all consumers, (2) champion the cause of those who deserve redress for injury to person or property, (3) encourage and promote changes to California law by legislative, initiative or court action, (4) oppose injustice in existing or contemplated legislation, (5) correct harsh, unjust and oppressive legislation or judicial decisions, (6) advance the common law and promote the public good through the civil justice system and concerted efforts to secure safe products, a safe workplace, a clean environment, and quality health care, (7) uphold the honor, integrity and dignity of the legal profession by encouraging mutual support and cooperation among members, (8) promote the highest standards of professional conduct, and (9) inspire excellence in advocacy. This post is a multi-blog effort to inform consumer attorneys about CAOC's value and encourage participation in CAOC through membership.

CAOC works tirelessly to protect or advance those causes of import to consumers and their attorneys in California. Often those efforts, though valuable, receive little fanfare. For example, CAOC recently sponsored SB 510, which affects the re-sale of what are known as "structured settlements," in which victims receive financial compensation over a period of time for medical expenses and basic living needs, as determined by a jury. Before SB 510 was signed by the Governor, Courts expressed frustration at their inability to prevent the sale of structured settlements on terms that might ultimately lead to long-term financial hardship for the victim. Now, SB 510 gives judges the information they need to make a reasoned decision about the propriety of a structured settlement sale.

Measures like CAOC-sponsored SB 510 help protect the most vulnerable members of our society and ask for nothing in return. They exemplify the spirit of CAOC. However, CAOC is only as effective in its mission as its membership allows it to be. When consumer attorneys join the ranks of CAOC, its voice gains in power and clarity. But if consumer advocates sit on the sidelines, hoping to benefit from the work of others, CAOC is stretched thin, and we are all at risk as a result.

Now, consumer advocate bloggers from across the state are combining their voices to call upon each and every lawyer and firm that regularly represents plaintiffs to join CAOC, thereby strengthening the consumer's first line of defense. The blogs participating in this unified call to action are:

• The Complex Litigator (H. Scott Leviant)
• The UCL Practitioner (Kimberly Kralowec)
• TrialLawyerTips.com (Mitch Jackson and Lisa Wilson)
• California Injury Blog (John Bisnar)
• San Diego Injury Lawyer Blog (Ross A. Jurewitz)
• San Diego Car Accident Lawyer Blog (Ross Jurewitz
• California Nursing Home Abuse Lawyer Blog (Walton Law Firm LLP)
• San Diego Injury Law Blog (Walton Law Firm LLP)
• Bailey Class Action Daily (Matt Bailey)
• California Employee Rights Blog (James J. Peters)
• An Appeal to Reason (Donna Bader)
• California Personal Injury and Insurance Blog (Jonathan G. Stein)
• California Debt Blog (Jonathan G. Stein)
• California Personal Injury Law Blog (Norman Gregory Fernandez)


• Biker Lawyer Blog (Norman Gregory Fernandez)

Show your support of consumers' rights by supporting CAOC. Together we can make an impact that we cannot make alone.

As America's elderly population continues to explode (it will double by 2030), an important question that has received little attention in the national healthcare debate is how the U.S. will be able to deal with 78 million aging baby boomers. Those of us who practice elder abuse and neglect law regularly see the costs associated with long term care, and let me tell you, it ain't cheap.

For many nursing home residents the story goes like this: there is an event that causes them to be hospitalized, whether it's an injury such as a fractured hip, or an illness. It is determined that after the hospitalization, nursing home rehabilitation is in order. The hospitalization and the first 100 days of nursing home care will generally be covered by Medicare. When the 100 days is up, and the person is determined to be too frail to return home, the financial obligation falls upon the resident, or his or her family. At $5,000 - $10,000 per month, this can quickly be financially devastating. If there is no money, or the resident's spends it all in the first months of care, they are typically qualified for Medi-Cal, and the taxpayers foot the rest of the bill, even if the patient spends the next five years in the nursing home.

This article at NewAmericanMedia.org addresses this very question.

Unlike any other economically advanced country, continuing-care coverage available to older Americans and people with disabilities is available mainly through Medicaid, a poverty program forcing people to "spend down" until they are poor enough to qualify. Private long-term care insurance is generally unreliable and covers only 6 percent of older Americans.

That's true. We rarely see clients with long term care insurance. As stated, the vast majority are Medi-Cal recipients, many of whom ended up there after spending down all their assets for prior care.

The high costs of long term care is an important issued that has been lost in the national debate over the capacity of the U.S. economy to handle the cost of comprehensive health care reform. Even though conservatives and the cable media have instilled fear in the American public that modest reforms would break the Treasury if they hit a staggering $1 trillion over 10 years — that amount would represent merely three percent of the $30 trillion projected over the coming decade in U.S. health care spending.

To read the entire article Health Care Reform's Missing Piece: Elder Care click here.

The elder 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.

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 Thousand Oaks 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.

At the end of last week, a Medicare rate adjustment that cuts $16 billion in nursing home funding went into effect. That cut, combined with state cuts, is creating conditions that are likely to put nursing homes in a state of crisis. In fact, the president of the American Health Care Association is predicting the nursing facilities will close their doors.

Already numerous nursing homes have closed their doors because of money problems, and many others have reduced staffing, creating conditions for substandard care. The crisis could not come a worse time, as baby boomers steamroll toward retirement and the need for skilled nursing care. Just last year U.S. nursing homes housed 1.85 million people, about 100,000 more than the previous year.

In Griswold, Conn., the community's only nursing home shut down earlier this year because of rising costs and an inability to pay for $4.9 million in needed renovations for the 90-bed facility."A 92-year-old woman was screaming and crying as she was loaded into the ambulance, saying 'This is my home,'" Griswold First Selectman Philip Anthony said. His 88-year-old mother was a resident of the same home at the time.

Long-term care is enormously expensive, and yet it is not discussed in this American debate about health care. Most of our living clients are on Medi-Cal and costing the state government from $5,000 - $10,000 per month. The long-term care industry has never seen such a crisis, and the prospects for more money for care are dim. While the federal stimulus package included $87 million in Medicaid funding (Medi-Cal in California), much have that has been diverted to alleviate other budgetary problems.

Source: San Diego Union Tribune

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.

California should take heed. Illinois has been housing mentally ill felons with the elderly in state nursing homes and the results have not been pretty. An elderly woman was raped by an ex-convict, a frail man had his throat slashed, and in one home a wheelchair-bound man died of massive head injuries that a doctor said it looked like he was hit with a baseball bat.

According to one report, mentally ill patients make up over 15% of Illinois' nursing home patient population, and among them are approximately 3,000 ex-felons with histories of serious crimes. Nursing home owners downplay that numbers of violent attacks, arguing they are miniscule in context to the whole, but there is a growing concern. The states largest nursing home owner's association has advocated an end to the practice, asking state officials to create separate facilities for those residents who may pose a danger to others.

While the population of U.S. residents is aging, those who can afford to do so are opting from home health or assisted living care over traditional nursing home or convalescent hospitals.

Source: Chicago Tribune

The Walton Law Firm represents seniors and dependent adults who have suffered neglect or abuse nursing home, residential care, or board-and-care setting. Cases are taken in all Southern California counties, including Los Angeles, San Bernardino, Orange, Riverside, and San Diego. For a free and confidential consultation call (866) 607-1325.

A report being released today by the Government Accountability Office finds that the federal program designed to identify and scrutinize the country's worse nursing homes is missing many of the poor performers. The Centers for Medical and Medicaid Services has identified about 136 nursing homes nationwide that are considered "special focus facilities" for their history of problems related to patient care, but many more questionable facilities are not making the list.

Herb Kohl, the chairman of the Senate Aging Committee wants more information about all of the poorest performing facilities on the government website Nursing Home Compare. The current report does not identify the homes.

"If far more than 136 nursing homes boast the bleakest conditions, then perhaps we should consider expanding" the program, said Kohl.

The GAO report also suggests modifying the methods used to identify the worst performing nursing facilities, since differing criteria are used in the various states. Comparing the homes on a national standard would ensure that resources go to inspecting the nursing homes that need the most attention.

To read the entire GAO report click here (.pdf).

Source: AP

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

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.

There is a growing movement to ban the common practice of requiring nursing home residents to waive their right to file a lawsuit in claims of negligence, abuse, or neglect in favor of arbitration. Last week, several consumer advocates testified before congress and criticized the practice of "forced arbitration."

Public Citizen released a report alleging that the practice of forced arbitration, essentially requiring a consumer to sign an arbitration agreement as a condition of being provided the service, has become pervasive. The report, "Forced Arbitration: Unfair and Everywhere" found that many industries, including nursing homes, banks, contractors, cable companies and auto sales, will require consumes to waive their right to file a lawsuit before the services will be provided.

For years, attorneys and consumer advocates have questioned the impartiality of arbitration, which usually has a lawyer or retired judge, or a panel of them, sitting as the trier of fact. The Public Citizen report reveals that arbitrators for the National Arbitration Forum (NAF), the largest arbitration firm in the country (but one of many), ruled against consumers 94 percent of the time.

With regard to nursing homes, the Fairness in Nursing Home Arbitration Act of 2009 is currently being considered by the U.S. House of Representatives. In current form, the Act would ban the practice of arbitration clauses in admission agreements.

Source: About Lawsuits

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

We write enough here about nursing homes that commit acts of abuse or neglect, so we thought we'd mention one that is being recognized for providing good care. A California Filipino-American owned nursing facility received a five-star rating from the US Department of Health and Human Services and the US Centers for Medicare and Medicaid Services.

Good Samaritan Rehabilitation and Care Center, in Stockton, was one of only a handful of nursing homes in the country to receive 5-stars in every measurement of quality of care. The Medicare Nursing Home Compare website provides categorical quality ratings for each of the 16,000 U.S. nursing homes. Good Samaritan received five starts in the areas of health inspections, quality measures, and staffing levels.

The owner of Good Samaritan said that the facility takes the ratings seriously, and continually looking for ways to improve care.

Source: GMA News

The nursing home 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 setting. For a free and confidential consultation call (866) 607-1325.

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

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

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

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

Source: Bakersfieldnow.com

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

It's not uncommon to hear nursing home residents to complain about the quality of the food being served. The Nevada state health officials decided to do something about it.

A routine survey last Tuesday by the health department of a North Las Vegas nursing home found some very serious food safety violations. Upon inspection, officials found a 16-foot hole in the ceiling of the kitchen that was leaking, it found perishable foods like chicken and beef being stored at unsafe temperatures, soiled and contaminated countertops, and an "overall inability of the staff to safely prepare food."

So what did the health department do? It didn't force the 240-bed facility to close down. Instead, it suspended the food permits, and required the nursing home to order food from local restaurants. The suspension only lasted for a day. The problems were addressed and the food permit reinstated.

The nursing home still faces the possibility of citations and fines.

Source: Las Vegas Sun

The San Diego-based 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 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.

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.

The Del Rosa Villa nursing home in San Bernardino received the state's harshest citation after investigators concluded that inadequate care led to a resident's suicide. The California Department of Public Health issued a AA citation and a fine of $90,000.

According to reports, on June 11, 2009 a 52-year-old resident was found hanging from a fence in the parking lot of the nursing home. He apparently had rolled his wheelchair through a back entrance to the nursing home and into parking lot where he hung himself with a belt

The man's care plan, which all skilled nursing facilities must maintain for patients, required that he be under suicide watch at all times, and that a nursing assistant admitted to investigators that she made a mistake. It was not the man's first attempt at suicide. He was in the facility from an acute care hospital where he was admitted after throwing himself in front of a moving vehicle.

In response to the citation, the nursing facility's attorney Elizabeth Tyler disputed the report that the resident required constant supervision. "We serve as a hospital," she said, "not a mental institution."

The nursing home may challenge the state's findings.

Source: The Press Enterprise

The San Bernardino elder abuse attorneys at Walton Law Firm LLP represent individuals and families who have suffered due to abuse or neglect in the nursing home setting. Call today for a free consultation.

The North County Times had a good column on the cold reality that elder abuse or neglect can happen anywhere. Susan Reichel, CEO of Advanced Home Health Services in San Diego says that an estimated 2 million elderly Americans are victims of elder abuse, whether its physical, mental, emotional, or financial, and it can occur in the home or at a nursing facility.

We, of course, know this. At this law firm, we take legal action against nursing homes and residential care facilities for abuse or neglect all the time. But it's always worth reminding people that such abuse cases are real and all around us. Remarkably, it is estimated that 84 percent of elder abuse cases go unreported.

The author makes a list of clues to look out for that might be signs of abuse or neglect, and we though it would be helpful to list them here.

● Unexplained injuries: bruises, scratches, fractures.
● Serious and persistent bed sores, signs of improper nursing care.
● Persistent or chronic infections ---- more signs of improper care.
● Sudden or chronic weight loss; is food being withheld?
● Unsanitary living conditions, linens not changed, clutter ignored.
● Increasing dehydration; is water being withheld?
● Sexual abuse: unusual bleeding, suspicious injuries, STDs.
● Repeated wandering by patients who have dementia or Alzheimer's disease.
● Excessive costs, financial fraud, overcharging on medical bills, etc.

San Diego has a variety of resources available if abuse or neglect is suspected. In an emergency, of course, call 911. The local office of Adult Protective Services can be reached at 858-495-5660. If mistreatment in a nursing or care home is suspected, call the Ombudsman Program at 800-640-4661 or call us at Walton Law Firm and we'd be glad to assist.

Source: North County Times

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 suffered from abuse or neglect in a nursing home or residential care setting. Cases are accepted throughout Southern California.

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.

Researchers analyzing 82 different studies on nursing home care found that nursing homes that are run as not-for-profit businesses offer better care than their for-profit counterparts. In the United States, less that one-third of all nursing homes are non-profit.

The 82 studies were from both the U.S. and Canada, and were completed between 1965 and 1983. Of the studies, 40 showed that non-profit nursing homes provided much better care than for-profits, while only three of the studies found that for-profit nursing homes provided better care. The remainder had mixed findings.

Importantly, the study suggested that non-profit nursing facilities did better in four important quality measures: higher quality staffing, lower rates of pressure ulcers and bed sores, less use of physical restraints, and fewer deficiencies cited by government regulators. Staffing issues, bed sores, and government investigations represent by far the basis for most of the nursing home abuse and neglect litigation in this law firm.

The findings of the study were published Tuesday in the British Medical Journal.

Source: Los Angeles Times

The nursing home neglect attorneys at Walton Law Firm LLP represent elder and dependent adults who have suffered abuse or neglect in the custodial care setting. Call (866) 607-1325 for a free and confidential consultation.

The Orange County nursing home Tustin Care Center has received a citation and a fine of $50,000 by the California Department of Public Health after a resident choked to death during lunch. A state investigation concluded that the nursing home's failure to adequately assess the patient's growing inability to eat as the cause of death.

According to the state report, the elderly man had been growing weaker over time, but that the nursing facility allowed him to continue to eat regular meals. In March, while eating lunch with his wife, who was also a resident at the Tustin facility, when he had difficulty breathing. As the patient struggled to breath, an attendant was called over, who tried to clear the airway.

The man died at a local hospital later that same day, and an examination found that food was completely blocking his airway.

Details about the Class AA citation can be found here.

Source: Orange County Register

The Orange County elder 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.

As California starts to overhaul the regulation of its 350,000 registered nurses, one of the nursing board's most promoted and trouble programs is under the microscope. The nursing drug diversion program, which seeks to help nurses maintain their licenses while they kick addiction to drugs, has apparently not been the success the nursing board would like the public to believe.

An investigation by the Los Angeles Times and ProPublica discovered several examples of nurses in the drug diversion program who practiced nursing while intoxicated, stole drugs from bedridden patients, and committed fraud to prevent from being caught.

Most troubling is that since the program was started in 1985, more than half the nurses who entered the program were unable to finish it and numerous nurses who failed the program were deemed to be "public safety threats." Yet despite the identification of incorrigible nurses, several continued to work after the findings were made.

These healthcare professionals may be in the operating room. They may be serving you when you're sick," said George A. Kenna, an addiction researcher at Brown University. "You just don't want that sort of person who's impaired" at the bedside.

To read the complete story in the L.A. Times click here.

The San Diego 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. Call (866) 607-1325 for a free and confidential consultation.

The great recession hasn't impacted everyone negatively. While the salaries and compensation for nurses has remained stagnant, the salaries for nursing home administrators have climbed to its highest rate in four years.

According to a study by the Nursing Home Salary and Benefits Report from Hospital & Healthcare Compensation Service, the average salary of a nursing home administrator rose by an average of 4.8% in 2009. The national average now hovers around $89,000 for administrators of nursing homes of all sizes, including not-for-profit facilities.

The study took samples from more than 10,000 nursing homes across the United States.

Source: McKnight's

The California State Assembly voted overwhelmingly to approve Assembly Bill 392, which would immediately restore $1.6 million to Long-Term Care Ombudsman programs throughout the state. Much of the funding to the programs was cut last year when Gov. Schwarzenegger vetoed the Ombudsman funding request.

In June 2009, a nursing home owner was arrested on allegations of criminal abuse and neglect, when a resident of his facility was so severely neglect that pressure sores went untreated and led to a fatal infection. Numerous nursing homes throughout the state have received citations for failing to provide adequate care of residents. Without an Ombudsman program, it is difficult to monitor the care the residents of these facilities.

"We need to take every step we can to protect seniors who may be at serious risk of abuse or exploitation," said Assembly member Mike Feuer (D-Los Angeles), who authored the bill. "The funds provided to Ombudsman programs in AB 392 fill this important need during the next year. Isolated and vulnerable residents of nursing homes and assisted living facilities have nowhere else to turn, and their lives depend upon these programs being restored immediately."

Source: California Chronicle

The California elder abuse and neglect attorneys 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.

Elder abuse cases are rarely reported, and even more rarely prosecuted. “Elder abuse cases, for whatever inappropriate reason, are not considered as severe,” said Riverside County District Attorney Rod Pacheco.

The reasons for the low reporting and prosecuting are varied. There is the embarrassment of being a victim, and in many cases - up to two-thirds - the elderly victim knows the abuser. But there is also the problem of ageism; the failure to take the matter seriously because the victim is elderly.

And it's not just the public that needs educating about elder abuse and neglect, but law enforcement as well. Riverside County has a special team dedicated to elder abuse cases, and it sees the ageism first hand. "They're old. They didn't have to live anyway," are the types of excuses heard by Tristan Svare, a San Bernardino deputy district attorney.

The problem is not expected to get better anytime soon. The California $26 billion budget shortfall may mean program cuts that would leave seniors more vulnerable. IHSS funding, which helps seniors avoid nursing homes, may be at risk.

Source: The Desert Sun

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.

It's been almost six months since Nursing Home Compare was launched, and all of the nations 15,600 nursing homes were listed and rated by the U.S. government. The reviews are in, and it's no blockbuster, but it isn't a flop.

For consumers, it's been mostly a good thing. It is the most complete nursing home rating website, which provides information about nursing staffing, state inspections, allegations of neglect. But some consumer groups want more details included about inspection results, and how staffing hours is calculated. Just counting workers, they say, is no indicator of the quality of care.

The nursing home industry, which tried to delay the website's rollout, says the grading system used by the site is misleading. Just because an allegation of neglect or abuse is made, it doesn't mean it has been substantiated.

Larry Minnix, the chief executive of the American Association of Homes and Services for the Aging, a trade organization for nonprofit nursing homes, believes that some important categories are not addressed by the rating system, and that nursing homes may not get credit for the care they actually provide.

Even though it has been six months since its launching, and receives 50,000 hits a day, the impact of the new site is unclear. Both the nursing home industry and patient advocates believe that most people don't know about it.

"Right now, many people making decisions about homes are in a crisis and pressed to make an immediate decision, and some simply don't know that the ratings exist online." said Gerald Kasunic, a long-term-care ombudsman.

Source: Washington Post

Nursing home abuse and neglect lawyers at Walton Law Firm LLP represent seniors and dependent adults who are victims of neglect, abuse, mistreatment, and malpractice in the nursing home, assisted living, and residential care setting. Cases in all Southern California counties are accepted, including San Diego, Los Angeles, Orange, Riverside, San Bernardino, Ventura, and Imperial.

One nurse twisted a patient's jaw until he screamed. Another grabbed an elderly man by the shoulders and slammed him against a mattress. Our 70-year-old client was punched in the face by an angry nurse while giving our client a bath.

Charles Ornstein of the LA Times is out with an article today about problem nurses. He highlights a very troubling fact: It sometimes takes years for a formal complaint against a nurse to be addressed by the California Board of Registered Nursing. As Ornstein writes:

It's a high-stakes gamble that no one will be hurt as nurses with histories of drug abuse, negligence, violence and incompetence continue to provide care across the state. While the inquiries drag on, many nurses maintain spotless records. New employers and patients have no way of knowing the risks.

The LA Times investigation examined the case of every nurse who faced disciplinary action from 2002 to 2008, and made some troubling findings:

• It took more than three years on average to investigate and act on complaints;

• The Board gave probation to hundreds of nurses, the failed to crack down as many of the nurses landed in trouble again;

• The Board failed to use its authority to immediately stop dangerous nurses from practicing;

Most troubling, the Times investigation found more than 60 nurses who were disciplined for "serious misconduct" since 2002 had worked in three facilities before action was taken.

Here at Walton Law Firm, we have been told that the nurse who punched our elderly client in the face continues to work at a different facility. Something needs to be done.

The entire LA Times story can be found 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 suffered from abuse or neglect in a nursing home or residential care setting. Cases are accepted throughout Southern California.

The U.S. Court of Appeals, 3rd Circuit has ruled that the Federal Nursing Home Reform Amendments grants residents of county-operated nursing homes the right to bring civil rights claims for allegations of abuse, neglect, or other care-related complaints.

The ruling arose in a case involving the 80-year-old Melvinteen Daniels, who died in a county-run nursing home as a result of neglect, malnourishment, and pressure ulcers. The family brought a lawsuit against the nursing home alleging, among other things, civil rights claims under Section 1983. Challenges to the claims wound their way through the courts and leading to yesterday's ruling.

In a 23-page opinion, U.S. Circuit Judge Richard L. Nygaard held that, "the language used throughout the FNHRA is explicitly and unambiguously rights-creating. These provisions make clear that nursing homes must provide a basic level of service and care for residents and Medicaid patients."

Nygaard also went on to hold that the FNHRA "guarantees" nursing home residents the right to be free from physical abuse, corporal punishment, involuntary seclusion, or restraints imposed for the purposes of discipline or convenience. (Read the opinion here)

The FNHRA was passed in 1987 as amendments to the Medicare Act, and designed to address nationwide concerns over nursing home care.

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

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.

By 2050, 1 is 6 people in the world will be 65 or older, forcing the countries of the world deal with an aging population. The number of senior has jumped an astounding 23 percent in the last decade.

According to studies, the world's population has been graying for decades due to declining birthrates and an increase in longevity. Italy, Japan, Germany and Monaco have the most senior citizens, with more than 20 percent of their respective populations over 65 years of age.

Here in the United States, residents who are 65 or older represent approximate 13 percent of the overall population, but that number is expected to double in the next 40 years. This raises serious concerns as to how we are going to be able to handle the growth.

"The 2020s for most of the developed world will be an era of fiscal crisis, with a real long-term stagnation in economic growth and ugly political battles over old-age benefits cuts," said Richard Jackson, director of the Global Aging Initiative at the Washington-based Center for Strategic and International Studies.

For example, at current aging rates, Medicare is projected to become insolvent by 2017.

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

State investigators issued a $100,000 fine to nursing home Aviara Healthcare Center in Encinitas after finding that a resident's death was caused by neglect. The resident died of blunt force trauma after a fall.

According to reports, the resident was at the nursing home to rehabilitate a broken hip, and suffered a fall on May 9 when trying to get out of bed. The following morning at 3 a.m., the resident got out of bed and stumbled into the hallway. A nurse saw him grab onto a large Hoyer lift (a large mechanical lift), which toppled over on top of the resident. The lift struck him in the head, causing a deep cut and a severe brain injury. He died three days later.

Investigators concluded that Aviara Healthcare was negligent for storing the large mechanical lift in the hallway outside the resident’s rooms, and received statements from several employees who stated that the lift was supposed to be stored elsewhere. As a result, a Class AA citation was issued.

Based in Carlsbad, the nursing abuse and neglect lawyers at Walton Law Firm LLP provide free consultations to individuals and families whose loved one has been injured or killed in the nursing home or assisted living setting. Call (760) 607-1325 for a free and confidential consultation.

A Westlake nursing home called Lakewood Manor North was issued the state's most severe fine after an 83-year-old resident died in January 2007.

According to reports, the patient, who was totally dependent on staff, lost his balance and fell when he was being transferred to his wheelchair, striking his head on a bed rail. Shortly after his fall, nurses noted bluish discoloration on the left side of his head. His condition continued to decline throughout the day, and the man complained of not feeling well. During the evening, after consulting with a physician, the man was transferred to a local hospital at 9:30 p.m., where he was diagnosed with severe bleeding on the brain. He died five days later.

Investigators with the California Department of Public Health faulted the nursing home for failing to take action earlier, when it was clear the resident was suffering a significant change in condition.

“Failure of the facility staff to immediately notify the physician and to provide the necessary care and services to [the resident]... presented a substantial probability that serious harm would result, and did result in the resident's death,” the report said.

Another serious matter not discussed in the article is why it took so long for the CDPH to complete its investigation. The resident died nearly two-and-a-half years ago and only now it has completed its investigation. If the family was just now learning about the wrongdoing of this nursing home it would not likely be able to bring any legal action against it because of statute of limitation problems.

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

A report published by the National Nursing Home Survey finds that between 1999 and 2004 the number of nursing home beds and nursing home residents declined in the United States. The number of nursing home beds dropped more than 10%, or 200,000 beds, and there are approximately 100,000 fewer nursing home residents.

The survey also found that more nursing facilities are certified for both Medicare and Medicaid, and that the vast majority of caregivers were not licensed nurses, but Certified Nursing Assistants. Also, it was found that a small fraction of nursing home residents are independent, and need no help with their activities of daily living, which a slight majority, 51.1%, needed assistance with all daily activities.

To read the entire survey, click here. (.pdf)

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

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.

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.

When Doris Weaver saw her mother's black eye at the local hospital emergency room where she had been taken from a nursing home, she was stunned.

"She had a bruise from her temple all the way down to her lower earlobe," said Weaver. "Her eye was black and was swollen."

Weaver demanded to know what caused her mother's injury, and even filed a police report, but to date she has gotten now answers...from anyone, even her mother, who cannot speak. [Read the entire story here]

Like elder abuse victims all over the county, Weaver's mother is unable to tell her story because of her advanced dementia. Because of memory impairment problems caused by dementia and Alzheimer's disease, many aging Americans under professional care are unable to communicate, and unable to tell family members when they are subjected to abuse or neglect. Our firm has one such case right now, involving a non-communicative Alzheimer's disease patient who was struck in the face by nursing caregivers, but unable to tell her horrible story.

Any unexplained incidents of bruising or dramatic changes in mental status should be reported to the resident's physician right away, and the local ombudsman office.

The Long Beach elder abuse and neglect lawyers at Walton Law Firm LLP represent seniors and dependent adults who are victims of neglect, abuse, mistreatment, and malpractice in the nursing home, assisted living, and residential care setting. All case consultations are free and confidential.

There is a short but solid article in a New Jersey paper today addressing the signs of elder abuse. New Jersey attorney Victoria Dalton lays out the real world signs and symptoms of elder abuse, which she defines simply as taking advantage of the elderly.

Physical Abuse

Physical abuse is simply the use of physical force which causes bodily injury, pain or some other type of impairment. It can also include hitting, shaking, slapping, kicking, or pinching. The signs to be aware of include bruises, broken limbs, welts, cuts, burns or marks.

I would add neglect to this list. Neglect is the failure to provide case and often reveals itself in incidents of malnutrition and dehydration, pressure sores, untreated infections. In realty, any unexplained injury, infection, or death can be a sign of physical abuse or neglect.

Financial Abuse

Financial abuse is more subtle, and is essentially the improper use of the senior's funds, property or assets. A common indicator of financial abuse is when the elder's contribution to household services is disproportionately high when compared to an adult child living in the home. Another tell-tale sign is a change in banking habits. Be aware of any large withdrawals by a person accompanying the senior.

Emotional Abuse

Emotional abuse typically includes intimidation, humiliation and harassment. Degrading remarks, or treating the elder like an infant, giving the older person the silent treatment, are also examples of emotional elder abuse.

Elder abuse can be stopped, Dalton writes, if we are simply more vigilant.

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 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.

In the promotion of an HBO series called "The Alzheimer's Project," The San Diego Union Tribune featured an interview with Dr. Paul Aisen, director of the Alzheimer's Disease Cooperative Study at UCSD, who is also featured in the series. Dr. Aisen is, if anything, very optimistic about the development of Alzheimer's treatments, and says that there are several excellent candidate drugs in clinical trials.

Do you think finding effective treatments, even a cure, for Alzheimer's is no longer hopeless?

I do. I think the likelihood is that in the foreseeable future, we will make very major progress in controlling the disease. The science has advanced to the point where we have highly promising targets for drug development, excellent candidate drugs in clinical trials. One or more of these current programs will be successful.

There are already some drugs on the market, though their benefits are fairly modest and symptomatic. They improve a little bit the cognitive symptoms of Alzheimer's without changing the disease or its course.

It will be different with the next generation (of drugs). They will target not the symptoms but rather the underlying pathology. Specifically, we recognize that Alzheimer's is driven by a specific molecule – the amyloid peptide. If we discover how to control the accumulation and toxicity of this molecule, we ultimately may be able to halt the progression of the disease. We're already making excellent progress at recognizing the disease at a very early stage.

For those impacted by this devistating (and incurable) disease, Dr. Aisen offers more than a glimmer of hope. It seems to just a matter of time before these treatments are available.

For the entire interview with Dr. Aisen click here.

An 89-year-old nursing home patient in Australia was bitten by mice, which shredded parts of his ears, head, and neck. According to reports, this victim of elder neglect was bedridden, and had the tops of ears severely chewed. A federal official, who has launched an investigation into the matter, said it was "extremely disturbing and traumatic" for the resident and his family. We couldn't agree more.

Here's a video report:

The San Diego elder 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.

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.

A study of bed sore rates in nursing homes with a high concentration of Hispanic residents found that Hispanics were more likely to have bed sores (or pressure ulcers) than nursing homes with less Hispanic patients. The researchers looked at two data sources, the Minimum Data Set, federally mandated health evaluations required for every patient, and the Oscar database, a collection of health information of nursing home residents.

"A systemic evaluation of the difference in the process of care between high- and low-quality nursing homes is warranted in order to reduce nursing home disparities," said Michael Gerardo, adjunct assistant professor at Brown University.

Only nursing home residents living in free-standing nursing facilities in Arizona, California, Colorado, New Mexico, and Texas were included in the study.

The elder abuse and neglect attorneys 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 Ombudsman Services of Northern California, an organization dedicated to creating a corps of compassionate advocates for residents in long-term care facilities believes that state budget cuts to its ombudsman program will lead directly to an increase in cases of elder abuse and neglect.

This year the organization, which tracks approximately 1,600 nursing homes and assisted-living facilities, lost two-thirds of its staff due to shortfalls in the state budget. According to Joan Parks, nursing facilities are already taking advantage of the lack of oversight.

"Our monitoring in these homes was seen as a form of prevention," Parks said.

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.

In increasing numbers, young and middle-aged mentally ill patients are being housed with older people in nursing homes. It has proved to be a dangerous practice for older residents. The younger, stronger, mentally-disturbed residents have lashed out at the older, frailer residents who often are defenseless against the attacks. Sons and daughters of the elderly victims of attacks are left wondering why their loved ones were not protected better.

In the past seven years, there has been a 41 percent increase in the number of mentally ill patients housed in nursing homes, which as led to a correlated increase in peer-on-peer physical abuse. The reasons for the increase are multi-fold, including the fact that states have failed to provide adequate facilities for the mentally ill. It is also financially advantageous to house the mentally ill and the elderly together. But while it may make financial sense, it puts the elderly at risk and inadequate measures have been taken to protect the elderly.

Under state and federal law, nursing home residents are guaranteed freedom from physical abuse. At Walton Law Firm LLP, we have represented victims of violent attacks in nursing homes. These attacks are often a result of negligence on the part of the facility including a failure to provide adequate staffing. If you have questions about the care of your loved one in a nursing home, please contact Walton Law Firm LLP for a free and confidential consultation.

Every year the typical nursing home will report approximately 1.5 falls per bed, and most falls go unreported. In fact, studies show that 75% of nursing home residents will fall at least once in a year, and nearly one-third of those involve a resident who is deemed non-ambulatory. Sadly, approximately 1,800 people living a nursing facility die every year due to a fall.

Can falls be prevented? Yes, and they should be. With proper care planning, many if not most falls can be prevented in the skilled nursing setting. For example, each resident must be accurately assessed on a regular basis for risk of falling, and when there is a fall, proper assessment must be performed to determine the cause of the fall, and how another might be prevented in the future.

In addition, physical changes in the nursing home can help prevent falls, including the placement of grab bars, lowering beds, and raising toilet seats. Bed alarms can also prevent a fall in a resident who is a known risk.

Yet, in our experience, many homes fail to take appropriate precautions after a resident is deemed a fall risk.

Not every fall is due to nursing home negligence, but many are. The nursing home abuse lawyers at Walton Law Firm LLP have litigated numerous cases involving injury causing falls in the nursing home setting, usually after the facility has failed to take appropriate measures after an initial fall. If you have questions about care in the nursing home, please contact Walton Law Firm LLP for a free and confidential consultation.

U.S. News & World Report is out with an article on the common problems found in U.S. nursing homes in an interview with attorney Eric Carlson, author of 20 Common Nursing Home Problems. As a nursing home abuse lawyer, I found the article enormously helpful; particularly the answer to the first question, which I think is the most important:

What can consumers do to best protect themselves up front?

Be aggressive about questioning a prospective home about staffing and staff training. A nursing home generally receives $4,000 to $9,000 a month for the care of one resident, so it should be responsive to both residents and potential customers. Talk to residents and visitors without nursing home staff hovering nearby. Visit several times, at different hours and on different days. Make at least one visit at mealtime. Examine inspection reports. Each nursing home that accepts Medicare or Medicaid payment is inspected approximately once a year. And the National Citizens' Coalition for Nursing Home Reform offers a consumer guide to getting good care in a nursing home.

Other questions include Alzheimer's care, nursing home staffing, and nursing home rights. I encourage all who are investigating nursing home care, or currently have a loved one in a nursing home to read the complete article which can be found by clicking here.

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

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.

California ombudsman Nona Tolentino's job is to investigate cases of suspected elder abuse in nursing homes. Her conclusion after years as in the business: be afraid, be very afraid.

The biggest problem Tolentino faces is trying to prove the allegations. "I call it the conspiracy of silence," she said, because many nursing home residents and their family are reluctant to talk about, frequently out of concerns of retaliation or being evicted from the facility. Tolentino believes strongly that nursing home residents have fundamental rights to be free from physical and verbal abuse, unnecessary restraints, or involuntary seclusion.

Tolentino is mostly right. If one were to visit the local office of the California Department of Public Health and pull the file of any large nursing home in the region where they lived, they would be startled by the number of complaints made and investigated. More troubling, however, would be the realization that the vast majority of complaints are "unsubstantiated;" meaning the investigator could not prove the allegations are true.

This is a real problem. Not that every complaint is meritorious, but that the investigation and enforcement of these complaints is very inadequate. In our office, we have litigated numerous cases involving horrendous cases of neglect or abuse where a formal state investigation had previously found no wrongdoing. Sadly, because of California's budget woes, this probably will not change anytime soon.

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

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

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

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

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.

Nursing Home Compare, a five-star rating system used to rate nursing homes nationwide, has been updated and upgraded by the Centers for Medicare and Medicaid Services. The updated website (click here) is intended to make choosing a nursing home easier for searching, and will hopefully have the effect of "outing" those poor nursing facilities that continually under-perform.

This is good news for consumers and nursing home advocates, and elder abuse lawyers. It is also sorely needed. U.S. Census figures project that the number of Americans over 65 will double by 2030, and two-thirds of those will require some period of nursing home care.

Bed rail entrapment is not a rare occurrence in the hospital and nursing home setting. Despite repeated warnings from consumer groups and the FDA, nursing facilities across the country are using hospital beds that violate well known FDA dimensional guideline addressing safe hospital beds and bed rails, creating in increased risk of suffocation and asphyxia.

The FDA has identified seven zones of entrapment, and made recommendations as to the acceptable dimensions of those zones to avoid entrapment hazards. Walton Law Firm LLP recently handled the case of an elderly woman who was found dead sitting on the floor next to her bed with her head wedged between the bars of her bed rail. She was literally hanging from the bed rail. The firm brought a lawsuit against the facility and the bed rail manufacturer for violations of FDA guidelines and other acts of negligence.

For those interested in learning more about the bedrail entrapment, and the identified zones, click here to see a diagram of the zones of entrapment. The video below is also an excellent instructional aid on the various ways a person can become entrapped in a hospital bed.

The New York Times has a story today about the dramatic increase in hospital patients with bedsores over the last 14 years. A report from the Agency for Healthcare Research and Quality finds that over 500,000 patients admitted to U.S. hospitals in 2006 suffered from a bedsore that was developed either before or during their hospital stay. That represents a whopping 78.9 percent increase over a previous study performed in 1993.

The failure to prevent or treat bedsores has been the basis of several cases here at Walton Law Firm LLP. Most legal claims arising from bedsores (frequently called "pressure ulcers" or "decubitus ulcers") occur in the nursing home or hospital setting, and involve a bed sore that became a Stage III or Stage IV before appropriate treatment was obtained. Sores that severe can often lead to secondary problems such as infection, and usually require painful treatment.

“Bedsores are preventable, but it’s not easy,” said William Spector, an agency researcher. “It’s not like you just get a prescription and one physician can take care of it. It’s a major team effort that requires a multidisciplinary team of dietary aides, nurses aides, physical therapists and physicians all playing a role.”

For the complete article click here.

If you or a loved one resides in any Southern California county and have a legal question related to the development of a bedsore or pressure ulcer, feel free to give the nursing home abuse and neglect attorneys at Walton Law Firm a call at (866) 607-1325 for a free consultation, or fill out our confidential online questionnaire.

The County of San Diego paid $1.6 million to settle a case filed by Ruth Lomeo against Edgemoor Geriatric Hospital, a county-run nursing home.

According to the lawsuit, Lomeo, who was only 44, was given an overdose of fentanyl pain medication by nursing staff at Edgemoor and began to have trouble breathing. It took over 20 minutes for 911 to be called and for emergency help to arrive. It was alleged that the lack of oxygen caused brain damage, and that Lomeo now communicates like a five year old, and cannot care for herself.

The County of San Diego denies all the allegations, and states its decision to settle the case was a business decision to avoid a jury verdict.

The overuse of medications is a common problem at nursing homes, whether done negligently or intentionally. The negligent overuse of medications arises in situations like Lomeo’s, when a previous fentanyl pain patch was not removed before a new one was placed. The intentional overuse often arises when facilities use medication to alter the behavior or “restrain” a resident. Both uses are unacceptable.

Walton Law Firm LLP represents people who have been impacted by abuse or neglect in the nursing home, residential care, or assisted living setting. Cases are accepted in San Diego County, Riverside County, Orange County, San Bernardino County, and Los Angeles County, and consultations are free.

The Des Moines Register reviewed 81 bonus payment programs in over 30 states and found that numerous nursing homes with a below-average care giving rating were receiving quality-of-care bonuses. The newspaper looked at eight federal bonus programs in states where regulatory violations by a nursing home do not automatically disqualify a nursing facility from receiving a bonus. The eight programs analyzed are costing taxpayers $313 million per year.

By way of example, the Grace Living Center in Oklahoma earned approximately $96,000 in bonuses during the last year despite federal records that show the home has been cite for more violations than the state or national averages. Toby Edelman of the nonprofit Center for Medicaid Advocacy called the bonuses "preposterous," and pointed out the incongruity of the government taking money from bad facilities by issuing fines, then returning the money in the form of a bonus. "It just doesn't make any sense," Edelman said, "it's totally confusing to consumers."

Legislation approved earlier this year says the bonuses will continue at least through June 2009.

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.

Elder Law and Advocacy in San Diego has been providing free legal services for seniors for 30 years, and was profiled in today's San Diego Union Tribune. Whether it's drawing up a will or a power of attorney, helping with a problem landlord, or answering questions about Medicare, Elder Law and Advocacy has assists several thousand San Diego County every year.

Walton Law Firm LLP has worked with Elder Law and Advocacy on cases involving nursing home abuse and neglect and can vouch for the organization's dedication to the plight of senior citizens.

Carolyn Reilly is the executive director of Elder Law and Advocacy, and says that the demand for free legal services for the elderly is rising - keeping her eight lawyers busy - while the funding for those services remains slim. Elder Law operates on a tight budget, with the vast majority of its income coming from grants and individual contributions. This is a worthy organization that deserves the public's support. It is well-known that a large part of our population is getting older, and organizations like Reilly's will only become in greater demand.

To contact Elder Law and Advocacy call (858) 565-1392 or visit its website by clicking here.

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

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.

A Laguna Hills nursing home faces its second lawsuit for elder abuse in three years for the neglect of one of its residents. In both cases the resident died.

Theresa Sperry died in July 2007 after a short stay a Villa Valencia skilled nursing facility. The lawsuit alleges that with two weeks of admission, Sperry developed pressure ulcers on both of her heels that were left untreated, and worsened to the point of spreading to her muscles and exposing bone. The complaint also alleges that Villa Valencia was not adequately staffed to care for its residents.

Pressure ulcers (also called decubitus ulcers or bed sores) are a big problem in nursing homes. The Orange County nursing home neglect lawyers at Walton Law Firm LLP have represented numerous nursing home residents who have developed very serious ulcers while under nursing home care. Most sores are a result of a combination of factors: poor nutrition, immobility, and neglectful treatment.

The Orange County nursing home lawsuit seeks unspecified damages.

A University of Chicago study reveals that approximately 13 percent of elderly Americans experience some sort of mistreatment. The most common form of abuse was verbal, experienced by 9 percent of elderly Americans, then financial mistreatment, experienced by 3.5 percent, and then physical abuse, reported by .2 percent of the elderly.

“The population of the country is aging, and people now live with chronic diseases longer. So it’s important to understand, from a health perspective, how people are being treated as they age,” said lead author Edward Laumann, the George Herbert Mead Distinguished Service Professor in Sociology at the University of Chicago.

The complete study can be accessed here.

Despite having the same odds at recovery, elderly trauma patients are being steered away from top trauma hospitals while younger patients are getting the better care. A new study finds emergency medical personnel are systematically discriminating against seniors. The study examined 10 years of data from ambulance trips in the state of Maryland and found that nearly half of all patients over 65 were not sent to designated trauma centers for care compared to only 18% of younger trauma victims.

Here’s the video story:

Walton Law Firm LLP represents people who have been vicimized 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.

Elder abuse lawyers have all seen cases of residents being evicted from nursing homes, or refused readmission, for dubious reasons. We sometimes call it Medi-Cal prejudice; that is residents being refused admission to a nursing home for no other reasons than they are Medi-Cal recipients.

One former client of our firm called a nearby nursing home hoping to find a room for her mother, who was about to be discharged from the hospital. The first question from the nursing home was whether her mother was receiving Medi-Cal. Medicare, or private pay. When the daughter told the nursing facility her mother received Medi-Cal, she was promptly told there were no available beds, but that her mother could be put on a waiting list.

Being a nurse herself and believing there were available beds, the daughter called the same facility the following day to see if there was room for her mother. Using a different name, she again asked if there were available beds, and this time, after informing the nursing home her mother received Medicare, she was told there were several rooms available, and that the facility would be happy to provide a tour that afternoon.

The Wall Street Journal reported this week that nursing homes across the country are refusing to admit, or are forcing out, frail and ill patients who are on Medicaid (“Medi-Cal” in California), because the facilities can make more money caring for residents on Medicare or private pay. Over the last decade, the number of complaints over the discharge practices of nursing homes has doubled, and the true number of force evictions is unknown, as it is believed most go unreported.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Robert Wood Johnson Foundation is donating millions of dollars to build small, home-like nursing homes as an alternative to the large institutional nursing homes we have come to know (and despise). Imagine what it would be like to have a country filled with nursing facilities like the one profiled in this video.

To read The Wall Street Journal article on the subject click here

A jury in Santa Ana awarded the family of Mary Adams $2 million after the 104-year-old was neglected in a Laguna Hills nursing home. The jury awarded $1 million for the Villa Valencia Health Care's negligence, and another $1 million in punitive damages.

Juror Rory Paster, a 41-year-old engineering analyst who lives in Huntington Beach, said the jury wanted to "send a message that the company should do a better job of treating patients."

According to reports, Adams admitted herself into the nursing home after suffering a fractured leg. Shortly after admission, Adams developed pressure sores on her heels, which were ignored, and not adequately treated. As a result, she contracted sepsis, and died about two months after her admission.

Attorneys for the family alleged neglect and wrongful death, including allegations that the facility’s owner, Sunrise Senior Living, purposely understaffed the facility in an effort to increase profits.

Nursing Home malpractice comes in many forms, and has many names. Some call it nursing home abuse or neglect, others elder abuse, but whatever the name, it’s increasingly becoming a problem in the United States. And it’s not just nursing homes. Residential facilities and home health care providers can commit malpractice as well.

Walton Law Firm LLP has represented victims of nursing home malpractice for more than a decade, and has learned that nursing home malpractice can come in many forms. The most common being simple neglect – the failure to notice a change in the resident’s condition, whether it be the occurrence of bed sores, the development of dehydration or malnutrition, or an obvious injury that is not promptly addressed. The law defines neglect simply as the failure to provide care for a person’s physical and mental needs, and to keep them free from health and safety hazards.

More serious cases are those of intentional conduct such as physical abuse, or the intentional mistreatment of a resident, often in retaliation for some prior act. Or the failure to provide basic care because of issues related to under staffing, such as cases involving multiple falls because staff would not respond to call lights. These cases can fairly be described not as just malpractice, but a conscious decision on the part of the nursing facility to expose residents to the risk of harm.

Ultimately, any unexpected injury, illness, infection, or death should be promptly investigated to determine if the underlying causes in nursing home malpractice, neglect, or abuse.

Walton Law Firm LLP represents individuals and families of victims of neglect and abuse in the nursing home setting. It accepts cases in the Southern California counties of San Diego, Los Angeles, Riverside, Orange, San Bernardino, Ventura, and Imperial.

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 U.S. Department of Justice is stepping up efforts to reduce nursing home mistreatment of elders through its Nursing Home Iniative. The iniative focuses on improving enforcement of existing laws, training, attention to medical forensic issues, and increasing the use of reliable criminal background checks.

Through its Elder Justice program, the DOJ is also increasing the enforcement of civil and criminal penalties against nursing facilities and others whose mistreatment results in the serious injury or death of elderly residents. It has also created State Working Groups to improve the coordination of federal, state, and local law enforcement in cases of health care fraud.

For more information, visit the DOJ's website here.

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

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.

Nursing home abuse and neglect is not always perpetrated by staff members. New research from Cornell University suggests that aggression and violence between residents may be more prevalent than abuse or mistreatment from nursing home employees.

According to the study, peer-on-peer abuse is nursing home is a problem that has received little attention.

"Given that nursing homes are environments where people live close together, and many residents have lowered inhibitions because of dementia, such incidents are not surprising," said Karl Pillemer of Cornell. "Because of the nature of nursing home life, it is impossible to eliminate these abusive behaviors entirely, but we need better scientific evidence about what works to prevent this problem."

The Cornell research examined a large urban nursing home and found 35 different types of verbal and physical abuse between residents. The most commonly found aggressive behavior was screaming, followed by physical violence such as pushing, punching, or fighting. A related study found that 2.4 percent of the residents had personally experienced physically assault from another resident, and more than twice that had experienced verbal aggression.

The authors of the study hope that their findings will assist nursing home staff better manage aggressive behavior among residents.

Washington D.C.'s most powerful lobbyists are being hired by the nursing home industry to fight congressional efforts to reform the industry. The industry is closely watching bipartisan legislation that would significantly increase oversight and enforcement of nursing homes around the country.

The new legislation, recently introduced by Sens. Grassley (R) and Kohl (D), would require nursing homes to fully disclose their ownership structures, and would increase penalties if a patient is injured or dies due to negligent or neglectful care. The industry is expected to pay millions to fight this legislation.

Why would nursing home owners disapprove so strongly of a law that requires them to disclose who actually owns and runs the facilities that provide them such a great profit? Liability. Many owners have created maze-like ownership structures that makes it nearly impossible to find out who actually owns the facility when something goes wrong. It's not uncommon to have a one corporate entity own the building, who then leases it to a second company (the nursing home), who then contracts with a third company to operate it.

Unbeknown to most, however, is that all three corporate entities are run by the same individuals. And when things go bad, the entity most liable for poor care, usually the operator responsible for the day-to-day care, has nothing to offer the resident that was injured or killed because the it carries no insurance, has no assets, and makes no profit. In effect, the victim gets victimized twice.

This new legislation would make the ownership structure transparent, which some advocates say is not enough.

It is nice to know [who the actual owners are], but then what?” said Toby Edelman, senior policy attorney at the Center for Medicare Advocacy. “How do you get these people to be not only identified but accountable?”

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).

Every skilled nursing facility (nursing home) in California is licensed by the California Department of Public Health (DPH). DPH, in turn, is charged with the responsibility of monitoring nursing homes in the state, which includes conducting annual inspections and investigating complaints of abuse or neglect.

Most complaints involve allegations of abuse or neglect of the nursing home resident, but any topic can be the subject of a complaint, including, but not limited to, poor staffing, unsafe conditions, mistreatment, transfer and discharge concerns, generally poor care, or a violation of patient rights. Once a complaint is made - and any person may make a complaint - the DPH will create a file and assign an investigator to the case. In most cases, the investigation is concluded within 90 days. For a list of local DPH offices click here.

If you have a complaint, it is usually a good idea to first address those concerns to the nursing facility itself, whether it is the administrator or the family council. If dissatisfied with the response, it is suggested to call the local ombudsman in your county for further advice. If a complaint involves serious allegations of abuse or neglect that has resulted in some injury, it probably a good idea to get the advice of an attorney with experience in nursing home abuse or neglect cases, such as the attorneys at Walton Law Firm LLP.

All complaints can be made orally or in writing.

A report from the Government Accountability Office states that widespread deficiencies addressing malnutrition, bedsores, medication errors, and abuse of nursing home residents are often understated.

Congressional investigators have confirmed in the report something advocates for the elderly have known for sometime. That is, nursing home inspectors routinely miss, overlook, or minimize problems in nursing facilities that can pose a serious risk to patient health.

In California, nursing homes are inspected once a year by the Department of Public Health, which sets the licensing standards. The GAO report found that state employees missed at least one serious deficiency in 15% of the inspections audited by the federal government.

“Poor quality of care — worsening pressure sores or untreated weight loss — in a small but unacceptably high number of nursing homes continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said.

The federal study was done at the request of Senators Charles E. Grassley and Herb Kohl who have introduced a bill to improve nursing home care in the United States, and increase the penalties for violations of federal standards.

The New York Times article can be found here. The GAO report is here (.pdf)

A jury in Arizona has awarded $6 million to the family of Sylvia Culpepper after the 81 year old died from an overdose of morphine in a nursing home. Culpepper, who was an active senior, was in the ManorCare nursing home only to recover from a back injury, and was expected to return home after her recovery.

According to reports, the nursing home resident was diagnosed with sciatica in late 2003, and prescribed 15 milligrams of morphine, twice daily. Two days later, while still in the hospital, her morphine dosage was doubled. When she was discharged to Manor Care, both of the prescriptions went with her, and the nursing home staff immediately began giving Culpepper both dosages, twice daily, totally unaware of the mix up.

Attorneys representing the family said the jury blamed the nursing home for failing to recognize morphine intoxication and overdose, and for understaffing.

"ManorCare gave her the morphine and within 24 hours of getting that dosage, she was dead. They weren't watching her," said attorney Brad Astrowsky. "The lesson in all of this is that you shouldn't get transferred to a nursing home on the weekend because the quality and quantity of the nursing staff is very often less than you would find during the week," Astrowsky said.

The jury's verdict won't have to be paid however as the case was settled before the jury reached its verdict.

When entering a nursing home, residents or their family are usually presented with a stack of documents that address everything from the fees to be paid to the type of pillow the resident prefers. More than a dozen signatures can be required to complete the admissions process. Often buried within that stack is an arbitration provision, a binding contract wherein the resident agrees that any disputes over nursing home malpractice, negligence, neglect, or abuse will not be resolved in the courts, but via private arbitration. Private arbitration is simply a process where allegations of neglect or abuse are resolved by a private judge (frequently a lawyer) and not a jury.

Last week, the American Association of Justice, the United State's largest trial bar, announced its support for legislation titled The Fairness in Nursing Home Arbitration Act, which allows the decision to arbitrate to be made after a dispute has arisen, not before in the admissions process.

According to the AAJ, the passage of this act will prevent corporate nursing home owners from manipulating the arbitration system in their favor and at the expense of nursing home residents.

Nursing home residents should not be forced to check their legal rights at the door in deference to large corporate interests", said American Association for Justice President Kathleen Flynn Peterson. "Mandatory arbitration denies nursing home residents access to the civil justice system and stands in the way of the quality long term care they deserve. By forcing people into a costly private system, the corporation sets the rules and hand-picks the players.

I can say with experience that most people learn for the first time that they have waived their rights to a court action in favor of arbitration when they contact our office with claims of nursing home negligence. They are usually not happy about it. And clients get more upset when they learn that they have to pay for a portion of the arbitrator's fee, which usually exceeds $250 per hour. Imagine an elderly victim of neglect or abuse being told that he or she has to pay thousands of dollars simply to seek access to justice. Now you're getting the picture of what arbitration is all about.

In California, approximately 200,000 claims of elder abuse are investigated every year by California social services. Because of proposed cuts to the California state budget, the ability to investigate claims of neglect or abuse could be reduced dramatically at a time when a greater portion of our population will be considered "elderly."

The director of the Center of Excellence in Elder Abuse and Neglect at UC Irvine is watching closely whether 75 social worker positions will be cut in the upcoming state budget. Mary Twomey stated that such a reduction in the investigation work force could translate into 20,000 allegations of elder abuse or neglect that will go uninvestigated.

Dehydration in the nursing home can lead to significant complications, including death. If the human body is deprived of necessary fluids, several symptoms may appear, including an increased heart rate, decreased sweating, decreased urination, extreme fatigue, headaches, cramps, and tingling of the limbs.

The causes of dehydration are several. The most common is vomiting, diarrhea, malnutrition, or the simple failure to replenish the body with the liquids that are lost from sweating and urinating. Sadly, this is the most common cause of the dehydration in the nursing home.

Nursing homes have a legal duty to provide adequate hydration to their residents, and to provide the proper training to their employees to recognize the signs and symptoms of dehydration. The aging process itself will often cause a decrease in appetite, but this is never an excuse for dehydration in a patient (even though it's an excuse frequently used by nursing homes). For patients at risk, nursing homes are required to monitor the food intake and urine output of its residents, and keep the medical doctor informed of the resident's condition. The failure to do this may be a violation of the standard of care.

If you have any questions about dehydration in the nursing home or residential care setting, call Walton Law Firm LLP at (866) 607-1325.

Living in a nursing home or assisted living facility continues to get more and more expensive. For a fifth consecutive year, the average annual cost for a private room in a nursing facility rose to $76,460. The costs varied dramatically state by state.

The costs for living in an assisted living facility also rose dramatically. Nationally, the average annual costs of living in an assisted living or residential care facility averaged $36,000, up 25% since 2004.

Experts believe that the costs of living in a nursing or residential facility will continue to rise if a shortage of long-term care workers is not resolved. As baby-boomers approach retirement, most have not adequately addressed the prospect of needing long-term nursing care in old age. The average person spends approximately 2.5 years in a nursing home, at a cost of over $190,000. Just a year or two in a nursing home can wipe out a persons lifetime of savings.

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.

Last week President Bush signed into law the Safety of Seniors Act, a bill dedicated to preventing injuries of the elderly inside the home. According to the CDC, one in every three Americans over 65 will suffer a fall their home, and nearly a third of those will require medical treatment. In addition, 80% of elderly Americans who suffer a serious fall will suffer an additional fall within a year.

The bipartisan legislation seeks to develop educational strategies to increase the awareness of falls, support research to identify populations at risk for falling, and encourage projects that promote fall prevention. In California, health officials say they will make fall prevention a major priority starting this summer.

According to the CDC, almost $20 billion dollars is annually on medical costs related to elderly falls, most of which is paid for the Medicare and Medicaid. Because of the aging baby boomers, that figure is expected to rise to $43 billion by the year 2020.

This comic strip is from the LA Times. We've had this case. The angry caregiver who assaults the nursing home resident, usually over some frustration related to care. Not so funny when it really happens.

A nursing home in Riverside County was hit with a $100,000 fine after the state deemed the death of an 87-year-old woman, who died of acute peritonitis in June 2006, was due to neglect. The home was also issued a AA citation from the California Department of Public Health, the most severe citation that can be given to a nursing home.

According to reports, The Springs at the Carlotta, a 59-bed nursing home in Palm Desert, the elderly resident had suffered from constipation for 24 days. The nursing facility allegedly knew the woman was suffering from constipation when she entered the facility only weeks before her death, but failed to monitor her condition or her treatment. When she began to vomit on June 22nd, she was sent to the hospital where tests confirmed that her colon had perforated due to the constipation. She developed severe peritonitis and died a week later.

It took more than a year for the Department of Public Health to complete its investigation, and the facility has appealed the fine.

These types of deaths occurring all the time in nursing facilities, and are rarely reported. I can only assume that an attentive family member sought to investigate what had happened, because most of the time a death like this is dismissed as just an old person who reached the end of her life, not the result of neglect or negligence by the nursing home staff. Good for the people who looked into this case, and kudos for the state for issuing the citation, even if a year is an appallingly long time to complete an investigation, but that's a topic for a different day.

Let's hope this family gets some justice for what was likely a very painful and suffering death.

Studies show that almost 50% of California nursing homes do not meet federal standards in preventing pressure ulcers. The problems are so widespread that the treatment of these ulcers – also called bed sores - will no longer be covered by Medicare if the sore was acquired after admission into a nursing home.

Family members should be aware that a bed sore can develop in only a few hours if an area of the skin is subjected to enough pressure that cuts off blood flow to that area. The skin will initially appear red and will be painful, slowing appearing to have a purple color. This is the best time prevent the sore from advancing to something more serious.

Nursing home and assisted living residents are at high risk for developing pressure ulcers, and those residents that are bedridden, wheelchair bound, or those will limited mobility must be examined frequently for the development of bedsores. A small bedsore can quickly become a large sore if treatment is not promptly provided.

Studies show that the best way to prevent these sores is a multidisciplinary approach, where all departments of the nursing home are involved in the prevention and care of bedsores, including departments such as laundry and maintenance. If you are responsible for a resident of a nursing facility, insist that the staff check frequently for the early stages of pressure sores, particularly the areas of the lower back and coccyx, and on the heels.

For more information about bedsore prevention and treatment, visit the Mayo Clinics website on the topic here.

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.

The signs and symptoms of a brain injury are not always as clear as you might think. Most patients who suffer a traumatic brain injury can walk, talk, and give the appearance of a normally functioning person. There are, however, symptoms that point to brain trauma.

The month of March is set aside to increase the awareness of traumatic brain injuries, which can be caused by a bump, blow, or jolt to the head. The Centers for Disease Control and Prevention reports that falls - particularly in people over age 75 - are the leading cause of brain injuries in the United States.

Those who care for the elderly should be aware of the symptoms of a brain injury. In a mild injury, a person might have a persistent headache, confused, or have blurred vision. Another symptoms is a lost of smell or taste. A more severe injury may cause vomiting, slurred speech or weakness in arms or legs.

In the elderly, the best way to prevent injury is to prevent falls. One way to prevent falls is to remove items in the home that can be a trip hazard such as small rugs or electric cords. Another way is to be aware of any medications that might increase dizziness or weakness, and to make sure that any vision problems are addressed.

For more information about preventing falls visit the CDC website.

Those of us who sue nursing homes and assisted living facilities for elder abuse and neglect of residents know how hard it is to uncover the evidence needed to meet our burdens of proof (which are higher than the typical case). Whether it's proving a systemic problem of understaffing, ignoring resident fall risks, or establishing false charting, the victims of abuse or neglect always face tremendous hurdles in proving they were neglected. In reality, it's usually the family trying to prove the wrongdoing since the victim is frequently dead because of the abuse or neglect.

What we certainly don't need is nursing home caregivers, through their union representatives, colluding with industry trade groups to lobby against the rights of nursing home residents all in the name of job security and wages. This disturbing article in the San Francisco Weekly suggests that for the Service Employees International Union this might be a goal.

According to the article, the two-million-member SEIU, the country's largest union, would offer political support for nursing home industry goals of limiting patients’ or families' right to sue for abuse and neglect in exchange for the right to organize nursing home employees in a number of California nursing facilities. This collaboration has led to a division within union ranks, and a growing dispute between SEIU's California healthcare affiliate and the national union office.

Whatever the outcome of this dispute, California nursing home abuse laws should not be weakened, and unionized caregivers should not be encouraged to overlook or ignore cases of neglect because of some real or perceived partnership with the nursing home industry. If anything, action should be taken to strengthen the rights of the elderly and dependent adults who find themselves in a nursing home, and whose very survival depends on the competency and commitment of those who provide daily care.

When there is sustained pressure in an area of skin that cuts off circulation to that area, the skin will start to breakdown creating what is common called a bedsore or pressure ulcer. If you've never seen one, consider yourself lucky. Not properly cared for, these sores and develop into wounds so deep that muscle and bone can sometimes be exposed.

It has been reported that two million Americans experienced pressure ulcers every year, usually the result of a combination of poor nutrition, dehydration, and immobility. Recent studies, however, suggest that fighting bedsores requires a team approach, enlisting not just the bedside caregivers, but many other nursing home employees.

A study by the Journal of the American Geriatrics Society involving 52 nursing homes around the United States reported a reduction of almost 70% of serious bedsores acquired in the facilities after utilizing a team approach to the prevention and treatment of sores.

“Preventing pressure ulcers is a 24/7/365 kind of job,” said Jeff West, a clinical reviewer at Qualis Health in Seattle, who helped to set up the collaborative in 2003. “It’s not as if one person can get it all done. And if it fails just a little bit, just during the weekends, for instance, you’re not going to get the results. It takes tremendous consistency.”

For example, laundry workers can help make sure clothes fit properly, kitchen staff can ensure proper nutrition, even the beauty parlor can help by assessing the risk of the customer and making sure a resident doesn't sit on one place for too long.

Bedsores should be rare events in nursing homes. While the development of these sores can not always be blamed on inadequate care, it is rarely the case that a State III or IV pressure ulcer could not have been prevented with proper attention and care.

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

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

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

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

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

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

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

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

Nursing home owners have claimed for years that they are barely getting by, and the lawsuits against them for negligent care are going to drive them out of business, leaving no place to put seniors. We reject this argument as a time-honored trick by tortfeasors to become the victims after causing harm to others. A New York Times article substantiated that the nursing home business is plenty profitable.

According to the Times, private takeover of nursing homes leads to poorer care, and increases the likelihood of nursing home abuse or neglect. A survey of complaints against more than 16,000 U.S. nursing homes found that care often deteriorates significantly after homes are acquired by large private investment firms.

The Times compared the number of complaints received against 1,200 nursing homes acquired by these for-profit firms against those of 14,000 other nursing homes.

The report revealed that, on average, residents of these homes are now much worse off in terms of depression, loss of mobility, and loss of ability to dress and bathe themselves than before the takeover, according to data compiled by the U.S. Centers for Medicare and Medicaid Services. Much of that shortfall in care is linked to drastic cuts in nursing and other staff in the months after an investment firm takes over the home.

“The first thing owners do is lay off nurses and other staff that are essential to keeping patients safe,” said Charlene Harrington, a professor at the University of California in San Francisco who studies nursing homes. In her opinion, she added, “chains have made a lot of money by cutting nurses, but it’s at the cost of human lives.”

Advocates for nursing home reforms say anyone who profits from a facility should be held accountable for its care.

“Private equity is buying up this industry and then hiding the assets,” said Toby S. Edelman, a nursing home expert with the Center for Medicare Advocacy, a nonprofit group that counsels people on Medicare. “And now residents are dying, and there is little the courts or regulators can do.”

There is something you can do. Go after those who cause the harm, plain and simple.

The National Pressure Advisory Panel updated its definition of the four “stages” used to diagnose pressure ulcers or decubitus ulcers (often referred to as bed sores). It also added two new stages on deep-tissue injury and ulcers that cannot be staged. The updated stages of pressure ulcers were released at the conclusion of its 2007 annual conference held in San Antonio, Texas.

A pressure ulcer or bed sore is a localized injury to the skin and/or underlying tissue, usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. In elderly or disabled patients, sores can begin on the skin of the tailbone, back, buttocks, heels, back of the head, or elbows. Poor nutrition or dehydration can weaken the skin and make it more vulnerable.

The new staging definitions are as follows:

Stage I. Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area.

Stage II. Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.

Stage III. Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

Stage IV. Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.

Unstageable. Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.

There is rarely a legitimate explanation for a pressure ulcer to reach the level of a Stage IV in hospital, nursing home, or assisted living setting. Any skin wound progressing to Stages III or IV should be viewed with a critical eye, and a physician should be involved in the care immediately. The development of pressure ulcers in the custodial care setting is one of the leading causes of lawsuits against nursing homes in the United States, and have been the subject of several lawsuits brought by the attorneys at Walton Law Firm.

The Centers for Medicare and Medicaid Services announced last month that, it will no longer reimburse hospitals for treating eight "reasonably preventable" conditions as of October 2008 the Wall Street Journal reports. Pressure ulcers are among the most prevalent, costly and dangerous on the list. In addition to interfering with recovery, lengthening hospital stays and causing extreme pain and discomfort, pressure ulcers can increase the risk of infection, with nearly 60,000 deaths annually from hospital-acquired pressure ulcers.

Nursing homes and long-term-care facilities have made strides of their own in prevention, motivated in part by the costs of lawsuits for failure to prevent bed sores. Prevention methods can include using ultrasound to identify skin breakdown before a pressure sore forms, special pressure reducing mattresses and ensuring that residents are turned at least every two hours.

Despite the availability of these, and other, prevention techniques, nursing homes have long failed to do much to prevent pressure ulcers as they had no real incentive to do so (other than the fear of lawsuits). Most commonly, nursing homes save money by not having enough staff on hand to ensure that residents receive the treatments required. They are then “rewarded” for this behavior by Medicare paying them extra money per patient to treat the decubitus ulcers. As of October of 2008, nursing homes will instead have to “pay” to treat pressure ulcers which they cause. Hopefully this disincentive will result in better care for all nursing home residents.

The federal Older Americans Act provides funding to states to fulfill the goals of the Act, namely the protection of the vulnerable elderly population. To receive federal funds, states must comply with a variety of statutory requirements, including the formation of an office of the State Long-Term Care Ombudsman.

Under federal law, the designated state ombudsman may designate a local ombudsman office to provide services to protect the health, safety, and welfare of long-term care residents. It is the job of the local ombudsman to “identify, investigate, and resolve complaints made by or on behalf of residents that relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of the residents.” (42 U.S.C. §3058g(a)(5)(B)(iii).)

Generally, any concerns about resident rights issues, physical abuse or neglect, transfer and discharge issues, or any other unexpected injury, illness, infection or death should be reported to your local ombudsman office. Reports of elder abuse or neglect are confidential, and will not be revealed in any legal actions that might arise from the complaints.

Remember, residents have rights, including the right to be treated with respect and dignity, the right to be free from chemical and physical restraint, and the right to voice grievances without fear of retaliation.

People with questions about nursing home elder abuse or neglect, or who desire more information about the complaint process, should contact Walton Law Firm at (760) 607-1325. All consultations are free and confidential.

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

A couple who operated a New Orleans area nursing home was acquitted of 35 negligent homicide charges and 24 counts of cruelty. Jurors believed the couple's mistake of staying in the nursing home during Hurricane Katrina should not be singled out and defense attorneys argued it was the government that did not do their job.

Providing nutritional support through feeding tubes to patients who are unable to eat enough orally to sustain themselves is an important component of supportive nursing care. Feeding tubes that enter the stomach through the abdominal wall, or percutaneous gastrostomy tubes (PEG tubes), can cause serious injury or death if misplaced or become dislodged. Nursing standards require that caregivers check the proper placement before using the tube for any purpose, whether it is for nutritional support, medication administration, or hydration. Failure to do so can expose the nurse and the nursing facility to legal liability.

Walton Law Firm currently represents two nursing home residents who were provided tube feedings after the tube was misplaced or became dislodged, causing tube feeding material to spill into the peritoneal space. Both patients became immediately septic, and one, a 73-year-old man, died.

Peer abuse in nursing homes is becoming more prevalent as the number of residents suffering from dementia or Alzheimer’s disease increases. Nursing facilities that accept individuals with dementia or Alzheimer's or any other psychological disorders have a duty to properly evaluate each resident and plan for the care of that resident in a manner that protects the resident, the staff, and all other residents of the facility. Failure to do so may expose the nursing home to legal liability. Walton Law Firm currently represents the family of a San Bernardino man who died shortly after being attacked in a nursing facility by a fellow resident.

Several recent news stories, including an article in Newsweek, highlight the growing problem of peer abuse in nursing homes. (Click link to see MSNBC's article: Nursing-Home Residents at risk For Peer Abuse)

An Alzheimer's patient was strangled by her bedrail while residing at an assisted living facility. She slid off her bed, became trapped between the mattress and the bed rail, and died from positional asphyxia. Bed rails, often used to prevent injuries, can be deadly if not used properly and under the right circumstances. Currently there are many defective bedrails on the market whose dimensions do not meet the current FDA recommendations. Walton Law Firm represents the family of the 90-year-old woman who is pursuing a claim against the residential care facility for the improper use of bed rails, and against the manufacturer and distributor for producing and supplying defective bedrails.

A skilled nursing facility placed an elderly resident in a room without air conditioning during last summer's heat wave. The resident died within 24 hours of admission. Walton Law Firm filed a lawsuit against the nursing home for failure to provide adequate care and accommodations.

An elderly woman developed a large bed sore while residing in a residential care facility. Because of inadequate treatment, the skin wound worsened and the elderly resident died only 10 days after being sent to a hospital for proper wound care. Walton Law Firm represents the woman's family in prosecuting the assisted living facility for failure to provide adequate wound care and treatment.

A severe hip fracture suffered by a resident of an assisted living facility went undiagnosed by facility staff for two weeks. The resident, who was ambulatory before the hip fracture, died approximately three weeks after being hospitalized for her injury. Mr. Walton filed a lawsuit against the residential care facility for failure to recognize the fracture.

Attorneys Randy Walton and Scott Barber form Walton Law Firm LLP to join forces in the prosecution of nursing homes and residential facilities for the abuse or neglect of residents. Walton Law Firm LLP will represent individuals all over Southern California who have experienced nursing home elder abuse or neglect, including against San Diego nursing homes, Los Angeles nursing homes, Orange County nursing homes, Riverside nursing homes, and San Bernardino nursing homes.