brandon-holmes-199535-unsplash-copy-300x200When nursing homes are cited for nursing home abuse and neglect in Poway, how are those citations determined? What can the type of citations a facility has received in the past tell potential residents about the quality of care at the facility?

It can be difficult to find a skilled nursing facility in Southern California that has a strong record when it comes to patient safety and patient care. One clear way to know that a facility has had problems in the past is to look into its citation history. However, nursing home citations can be difficult to understand. While a citation of any sort indicates that there is a problem, the different citation levels, including the most serious of the penalties, do not always clearly indicate by title alone that the facility has been cited for a serious incident of nursing home abuse or neglect. The following will explore these citations and describe the different categories.

Class AA Nursing Home Citations are the Most Serious Citation

Walton Law Firm recently settled the case of A.Q., a 78-year-old woman who died tragically after acquiring multiple bedsores that developed and worsened while she was under the care and treatment of a San Diego home health care agency.  Ms. Q was survived by her three children who brought a legal action for both wrongful death and elder abuse and neglect, contending that the result of careless and reckless conduct committed by a license vocational nurse (LVN) who ignored the development and worsening of Ms. Q’s wounds, and failed to notify a physician of the severity of the wounds or make a request for Ms. Q to be sent to the hospital.

Walton Law Firm initially argued that the pressure sores suffered by Ms. Q were the result of negligence, and that such negligence was a substantial factor in her premature death. The home health provider, it was argued, failed Ms. Q when it 1.) failed to obtain an air mattress for Ms. Q as requested by caregivers, 2.) failed to obtain additional nursing care for her when it was obviously needed, 3.) failed to have Ms. Q seen by a registered nurse or mobile physician, and 4.) failing to have Ms. Q transferred to a hospital where she so obviously need to go. 

In addition, Mr. Walton also contended that the treatment of Ms. Q was so egregious, that it rose to the level of elder neglect under California law. In order to show neglect, Ms. Q (through Walton Law Firm) had to show that the home health agency either failed to use the degree of care a reasonable person would have and/or failed to protect Ms. Q from health and safety hazards.  It has had to show these failures were done with the conscious disregard for the rights and safety of Mr. Q.

josh-appel-423804-copy-300x225Whether nursing home patients reside at a skilled nursing facility in Escondido or elsewhere in California, they now have greater protections against elder abuse and neglect. According to a recent article in the Los Angeles Times, a new California state law requires that patients receive a minimum number of hours of care from certified nursing assistants (CNAs). The law took effect on July 1, 2018, but will patients see an immediate change in the way staffing works at nursing homes across the state? Will staffing increases reduce the rates of nursing home neglect in the state?

Staffing Requirements Stricter, But Will Facilities Meet Those Requirements?

Under the new law, what kinds of staffing requirements are required at nursing homes in Escondido and throughout California? As of July 1, facilities must provide each patient with at least 3.5 hours of direct care every day. This number increased from a previous requirement of 3.2 hours of direct patient care per day. But that change is not the most drastic of the shifts in the law. The significant change is that at least 2.4 of these daily hours of direct patient care must be provided by CNAs.

rawpixel-487102-unsplash-copy-300x207One of the most common reasons that seniors sustain serious injuries from nursing home neglect is understaffing. When skilled nursing facilities do not have enough staff members, there are not enough people to provide the necessary care to patients and residents at the facility. Both California state law and federal law require skilled nursing facilities to have a specific staff-to-patient ratio to help ensure that seniors are getting the care they need. However, according to a recent article in The New York Times, many nursing homes across the country have been overstating their staffing numbers in order to be in compliance with state and federal regulations. As a result, patients have been suffering from nursing home abuse and neglect.

Federal Data Shows Inadequate Staffing Levels at Many Nursing Homes

For many years, according to the article, numerous family members of seniors in skilled nursing facilities have worried that staffing levels were insufficient. As it turns out, many of those suspicions and fears have some validity to them. Indeed, “on the worst staffed days at an average facility, the new data show, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.” Records also showed that there were significant fluctuations in staffing numbers at many facilities from day to day, with some days having adequate staff while others had grossly inadequate staff on hand to meet the needs of the residents.

jorge-lopez-284336-copy-300x200Did you know that a majority of elder abuse cases in Vista and throughout California likely go unreported? According to a report from Calaveras Enterprise, research suggests that “for every case of elder or dependent adult abuse known to agencies, 24 more are unknown.” Crimes against seniors in Southern California more generally are on the rise. The City of San Diego predicts that less than 20% of all incidents of elder abuse and neglect are reported in San Diego County. How can raising community awareness help to increase the rates of nursing home abuse reporting in Vista?

Nursing Home Abuse and Neglect is Vastly Underreported, but Raising Awareness can Help

In short, elder abuse is underreported. According to a report from Kusi News, reports of violent crimes against older adults in San Diego County rose by about 37% between 2016 and 2017. In each California county, more than 300 reports of suspected elder abuse are logged each year. If we accept that, for every single case reported there are 24 more unreported cases, that fact would mean that there are more than 7,000 incidents of elder abuse each year in San Diego County. Each month in California, the state Adult Protective Services (APS) gets more than 15,000 reports of elder abuse in the state, and the California Association of Area Agencies of Aging indicates that the number of reported abuse incidents is slowly increasing.

DSC_0761-300x199Residents of Carlsbad who have an elderly loved one in a nursing home or assisted living facility nearby, or who are currently exploring facilities for a loved one, should know about the risks of elder mistreatment and nursing home abuse. Every year, organizations in California and throughout the country take steps to address the continuing high rates of elder abuse, yet seniors continue to suffer preventable injuries as a result of abuse and neglect.

At the start of 2019, two new elder mistreatment prevention initiatives aim to take different approaches to the problem. We want to discuss these new efforts to detect elder abuse in emergency departments.

Elder Abuse as a Social Justice Issue

jyotirmoy-gupta-443923-unsplash-copy-300x200Falls are a serious problem among elderly residents of Carlsbad nursing homes. For seniors who live at home, a dangerous fall can mean the difference between being able to live independently and requiring daily care at a skilled nursing facility, according to the National Council on Aging (NCOA). Slips and falls, as well as falls from heights, often result in permanent disabilities and sometimes death among elderly patients. As such, it is important for researchers, physicians, and caregivers to continue seeking out new ways of preventing falls in nursing homes and assisted-living facilities across Southern California and throughout the country. In some situations, a serious fall may be the result of nursing home neglect or nursing home negligence.

According to a recent public radio report, a small sensor developed by researchers at Carnegie Mellon University may help to reduce the rate of falls among older adults.

Falls are Common in Nursing Homes and Assisted Living Facilities

rawpixel-487102-unsplash-copy-300x207Many families with elderly loved ones in nursing homes in Oceanside know about the risks of overmedication, particularly in dementia patients. For example, an article in U.S. News & World Report discussed the continuing epidemic of overmedicating dementia patients with antipsychotic drugs, reporting that more than 179,000 patients receive drugs every week that are “not appropriate for their condition.” Many of these medications are prescribed because of their “sedating side effects,” used to keep seniors suffering from Alzheimer’s and other forms of dementia “easier for overworked nursing home staff,” according to the article. Yet it is not antipsychotic drugs that are on the minds of many Americans who are concerned about overmedication or misuses of prescription drugs. This category has become reserved for opioids and news of preventable overdoses. What role do opioids play in the nursing home setting?

According to a recent report in the Washington Post, seniors are also grappling with the opioid epidemic, and many older adults are at risk of serious injury as a result of using these drugs.

Opioid Abuse on the Rise Among Older Adults

jorge-lopez-284336-copy-300x200Elderly residents of skilled nursing facilities (SNFs) in San Clemente and throughout California could lose important federal protections against nursing home abuse and neglect, according to a recent article in Lake County News. However, California Attorney General Xavier Becerra is working to prevent this from happening. As the article explains, “Becerra has led a coalition of 16 states and the District of Columbia in submitting a letter to the United States Department of Health and Human Services (HHS) and its Centers for Medicare and Medicaid Services (CMS).” The letter “condemn[s] federal actions that would delay the enforcement of protections for Medicare and Medicaid beneficiaries who receive care in skilled nursing facilities.”

In 2016, regulatory reforms resulted in improved “protections against abuse, neglect, and exploitation.” During the June rule-making period, Becerra and other attorneys general have “grave concerns” that the federal government will “revisit requirements deemed to be burdensome for facilities.” In other words, Becerra and others expect that CMS will change the way it deals with protections for seniors in SNFs, allowing facilities to be less burdened by regulations, thereby jeopardizing the health and safety of the patients at these facilities.

Revisiting the Long-Term Care Reforms of 2016

parker-byrd-139348-copy-300x200Can Yelp help Valley Center seniors avoid nursing homes with histories of elder abuse or neglect? Most residents of San Diego County think of Yelp as a crowd-sourced set of reviews for businesses like restaurants or retail establishments. However, according to a recent article in The New York Times, Yelp also might be able to provide helpful information about nursing homes and assisted-living facilities to patients and their families who are looking for places with high ratings.

Given that nursing home abuse and neglect is a serious problem across Southern California and throughout the state, using an unlikely source such as Yelp to find reviews can not hurt. As the article points out, “gerontologists at the University of Southern California have been looking into Yelp nursing home reviews and think they make a useful addition to the homework any prospective resident or family member needs to undertake.”

Using Crowd-Sourced Information to Choose a Skilled Nursing Facility