California Elder Law Attorney Blog

One in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality, a USA TODAY analysis of new government data finds.
More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009

USA TODAY found that all 50 states and the District of Columbia have homes with poor ratings from one year to the next. And dozens of those facilities are the only nursing homes for miles.

Late in the Bush administration, the Centers for Medicare & Medicaid Services began assigning nursing homes one to five stars for quality, staffing and health inspections, as well as an overall score. Nearly all homes that repeatedly received few overall stars -- one or two stars -- were owned by for-profit corporations, the data show.

"We want to see improvements, but we don't expect a nursing home will jump to a five-star rating within a one-year time period," says Medicare's Thomas Hamilton, who led the development of the rating system. He points to "positive trends" within the past year, including the reduction of one-star homes and vigilance among providers in the use of restraints.

"The issue is the owners have to take responsibility for the consequences" of poorly performing homes, says Larry Minnix, CEO of American Association of Homes and Services for the Aging. He says the nascent star-rating system should account for patient satisfaction.

Medicare spokeswoman Mary Kahn says a one-star nursing home is not necessarily a terrible facility. Even the lowest-rated homes must still meet baseline Medicare conditions, she says.

The newspaper's analysis found the lowest-rated homes had an average of 14 deficiencies per facility, which can include quality-of-life measures and safety violations.

"Families can show (a home's rating) to a hospital discharge planner and say, 'I'm not going to send my mother to a home with one or two stars,' " says Janet Wells, public policy director of NCCNHR, formerly the National Citizens' Coalition for Nursing Home Reform.

"If homes are not motivated to get better, chances are they won't, and you'll wind up in homes in poor-quality purgatory," Minnix says. "There should be two types of homes: the excellent and the non-existent."

Continue reading "One in Five Nursing Homes in the United States Receive Poor Ratings" »

It could be human nature to say that such a thing could never happen to anyone. An attorney that specialized in Elder Law and protecting the elderly, was hired after researching the best, moreover, the attorney referred the client to a home health aid to monitor his mother in the nursing home to shield her from and report any abuse.

Even more, client hired a financial adviser to monitor her investments and pay bills when necessary. Additionally, client employed a property manager to manage, lease, maintain, collect the rents from her home and deposit the proceeds into her account. So how was it possible that this support system collapsed, completely states California Elder Law Attorney Steven C. Peck.
The home health aid, recommended by both the attorney and the financial adviser, told client his mother had to sell her home to pay for her medical expenses. Red flags went up. Perhaps unknown to the home health aid client had enrolled my mother in a Kaiser Permanente medical insurance program and had taken out long term care insurance as well.

Client's suspicions that the home health aid was lying about the cause of the sale of the home were confirmed with the appearance of the tax statement. Only two thousand dollars in medical expenses. During the police interview, the home health aid stated that she "misspoke" and stated instead that the home was sold because of the expense of cost for repairs. The cost of the repairs, $10,000. As shown in the real estate sales contract, my mother reduced the sales price of her home to the buyer by $10,000 to make the stated repairs. sounds like more than a red flag indicates California Elder Abuse Attorney Peck.
The home had been generating $10,000 a year in rental income for client's mother. She had owned the home for twenty-five years and it was insured against damage and fire.

Client's mother's attorney, during an interview by law enforcement, stated that "no rights whatsoever" were given to the home health aid. A false representation, according to court documents the home health aid had acquired financial Power of Attorney. Client discovered the transfer of my Power of Attorney to the home health aid after client's mother's death. Very suspicious? The law enforcement officer could have verified the attorney's statement and claims by checking county public records or asking the attorney for a review of my mother's legal file. This was not meant to be.

Meanwhile Client started asking questions of others- the financial adviser, the real estate broker, the property manager, and the financial advisers,client's mother's home was put on the market and sold for a profit of US$300,000. An attorney informed client that the home was probably sold so that the sale of the home could not be rescinded. The sale of a home under emotional duress and a sale based on fraudulent foundation could be rescinded. in many instances states Los Angeles Elder Abuse Attorney Steven C. Peck.
Kaiser Permanente physician Barbara Paul, M.D. recorded in the Patient Progress Report six days before mother, age 87, signed the contract to sell her home that "Since Thursday a lot of probs piling up/decisions going in circles/trouble deciding what to do. Now w/songs playing over and over in her head for almost a week. A/P Paranoia w/auditory hallucinations".

For the past week the home health aid had been taking client's mother to meetings with the attorney, financial adviser and real estate broker about selling her home. All eventually benefited by the commissions and fees earned directly from the sale of the home and these are the trusted individuals?

Shortly after client's mother signed the contract to sell her home, she was admitted to Kaiser Permanente Emergency Room with the presenting complaint, "I had to give up my home." According to Kaiser Permanente medical report, three days later she was diagnosed with Dementia.

The law enforcement investigator, according to the police report, who was assigned to investigate client's complaint did not interview the physicians or psychiatrists who had provided treatment for my mother. He could have interviewed them about client mother's state of mind before, during, and after she signed the contract, but no interview took place... even after client's complaint was published as front page news in a local paper. Client mother's attorney stated to the law enforcement investigator my mother was "mentally competent" to make the decision to sell her home, as well as manage her financial affairs. According to the police report, the police investigator diminished the seriousness of my mother's mental state.

The attorney selected the real estate broker that sold the home. The real estate broker who listed and sold the home reported to the police investigator that client mother, mentally, was "sharp as a tack". All proceeds from the sale of the home were used to open a new account at a stock investment company managed by a business associate of the attorney, Northwestern Mutual. The attorney stated that the account was shut down after the collapse of the stock market. The attorney stated that the remaining funds were transferred to client mother's original account at Prudential Securities. That does not make sense to me. The police report does not mention what the opening balance was at Northwestern nor the closing balance. The new Northwestern financial adviser was never interviewed during the police investigation. The closing balance equaled the opened balance. Does that constitute the failure of the account? The police investigator could have asked these questions. Is the transfer of the funds from Northwestern to Prudential a statement of Northwestern's incompetence, or were the funds transferred for a different reason? When client asked questions about client mother's Prudential Securities financial adviser about her account, the financial adviser stated,"You are getting my hackles up!!!"

Client then filed a complaint with the Securities and Exchange Commission. Their email response to the client complaint was this, "Hire an attorney. It is your word against theirs." and that was the last client heard from them. Client does not have $75,000 to hire an attorney. Elder abuse and fraud persist for these very reasons. Complaints filed with regulatory agencies are but voices in the wind. Legislation passed to fight against elder abuse is worthless when regulatory agencies do not respond and follow through with filings by complainants. The result of these types of responses has a horrifying and stun to silence effect on the complainants and the victims.

The home health aid wrote a note to Kaiser Permanente instructing them to contact her and not client regarding any issues involving my mother. This information, written on a small yellow sticky note, was recovered when client obtained client mother's medical files from Kaiser Permanente after her death.

The home health aids´ invoices recovered after client mother´s death showed billings for up to $60.00 a day at $20.00 per hour for cleaning her room at the nursing home. Room cleaning and maintenance had been included in the services provided by the nursing home and those services were billed for in the monthly nursing home fees.

Client then actually reported client's complaint to the State of California Governor's Office emergency response unit for elder abuse. Agent Araceli Flores was assigned to client's complaint. Agent Flores met with client several days later. Then she spoke to the police investigator assigned to investigate client's complaint. Client waited a month for a response from Agent Flores. Nothing.

Client then called her at her Sacramento office asking her what had happened, why had client not heard from her. No one answered the phone. Client then left a telephone message with her answering service, cries and pleading to her for her to continue her investigation and please contact client. She never responded. Client then called her supervisor leaving a message for help. Again, no response.

Two months later, client received a banker's box from the State of California elder abuse investigating unit containing the files client had given to Agent Flores for review. There was no cover letter in the box, only client's research and findings involving my complaint.

After reading the police report involving my complaint client learned that Agent Flores was convinced by the police investigator to drop my complaint.... everything would be taken care of on a local level. No need for an independent investigation by State of California officials.

The police investigator could have allowed Agent Flores to continue her investigation. What would have been the harm? Allowing the State of California to conduct its own independent investigation would have not cost the local police department any cost in labor hours or any other of its resources. It was about that time that client stopped contacting other state and federal agencies about client's complaint. Crushed and demoralized, Client thought any other independent investigation would be shut down by the local police department.

At the time of client's interview with the police investigator, he informed client that the home health aid still had some of client mother's funds in her Prudential Securities account. A year and a half had passed since client mother's death. Client asked the police investigator why client mother's attorney, financial adviser, or home health aid had not informed client of the existence of these funds? The police investigator responded, "The money is probably being used to pay bills." A year and a half after client mother's death? What bills? No accounting was provided showing what bills remained unpaid. During the entire course of client's independent investigation, the home health aid refused for over one year to respond to client telephone calls, emails, and USPS certified mail client had sent to her. She cancelled her email account. What was client mother's money doing in the home health aid's account? And, an account with Prudential! Approximately two weeks after the police investigator was informed of the existence of the funds client received a check from Prudential Securities for $6,300.00. There was no letter providing an explanation for the check. The check did not list the home health aid's name. The name of a subsidiary company of Prudential was named as payee.

Client mother´s elder law attorney is still in business today. The real estate broker and the financial adviser, both working for international corporations, remain in business. The home health aid, according to her attorney´s court testimony "lost her business" of $60,000 a year. No demand for retraction of information client provided the three front page newspaper articles about those people was made. No counter lawsuit for defamation or libel was filed.

Client is now in litigation and is in a state of emotional and physical collapse under the multiple pressures of the shocks of discovery, trial preparation, key witnesses repeated refusals to accept subpoenas, the police investigator now asking client to change the date of the trial, client's uncertainty if I had answered demurs correctly, strict protocols for court document preparation, court deadlines, trial management meetings, settlement conference preparation, preparation for deposition and cross-examination questioning of the defendant and the witnesses. Client was unable to take the legal proceedings as a result of the deteriorated emotional and physical condition client was in and suggested client as a result thereof drop legal proceedings. Client agreed. Immediately client's attorney called the defendant's attorney and said, "We have a settlement!"

Continue reading "Elder Abuse - Real Estate Fraud - Financial Fraud: A Typical Sad Scenario" »

In New Jersey, if you are a firefighter, an EMT, a nurse, an optician, a podiatrist, a dentist, or any licensed health professional, you are now required to report suspected abuse, neglect or exploitation of persons over age 18 years to Adult Protective Services.

Every county in New Jersey has an agency that receives these reports and investigates.

Often times, these reports require many visits to determine the facts and to address the needs of the victims.

This law now identifies new legal responsibilities for first responders and health care professionals. More than 18 different health care professions are now required by this law to report abuse, neglect or exploitation of a vulnerable adult. These groups included acupuncturists, chiropractors, social workers, occupational therapists, audiology and speech therapists, to name just a few.

Grace Egan, the executive director of the NJ Foundation for Aging noted, "This law creates a new focus on the silent victimization of vulnerable adults. Now, professionals who work with seniors are required to report which is the first step to ending this cycle of violence. National statistics indicate that only 1 in 20 incidences of abuse or neglect is reported. While this law does not go far enough to provide financial support for more needed services, it does create a legal requirement for professionals to report."

This law requires reporting of abuse against a vulnerable person who is living in the community. A "vulnerable adult means a person 18 years of age or older who resides in a community setting and who, because of a physical or mental illness, disability or deficiency, lacks sufficient understanding or capacity to make, communicate, or carry out decisions concerning his [or her] well-being and is the subject of abuse, neglect or exploitation." .

Reports of abuse against institutionalized persons are investigated by the Ombudsman for the Institutionalized Elderly. This office investigates and responds to complaints of abuse, neglect and exploitation of individuals 60 years of age and older who reside in licensed facilities within the State, both public and private.

Continue reading "New Jersey Law Now Requires Mandatory Reporting of Elder Abuse, Neglect, and Exploitation" »

Four of the alleged victims in the highly publicized elder abuse case at Good Samaritan Society of Albert Lea and their families have sued the operator of the nursing home and four of the former certified nursing assistants.

The civil lawsuit, filed Monday in Freeborn County District Court, comes on the heels of criminal trials slated for this summer.

At a press conference Tuesday afternoon, lawyers with two Minneapolis law firms said the four plaintiffs in the civil lawsuit are alive and are acting in the case via power of attorney granted to relatives. The power-of-attorney relatives filing the suit are Kathy Iverson, LeeAnn Hojberg, Paul Knutson and Morris Blom. The Tribune has withheld the names of the alleged victims.

Former nursing assistants Brianna Broitzman, Ashton Larson, Alicia Heilmann and Kaylee Nash are defendants in the case, along with the Evangelical Lutheran Good Samaritan Society, which runs nursing homes in many Upper Midwest cities including the Good Samaritan Society of Albert Lea, where the acts of physical, sexual and emotional abuse of residents with dementia are alleged to have occurred.

The four former nursing assistants in the civil suit were teens, two of which face juvenile criminal charges and two of which face adult criminal charges. All are now adults. Two others not cited in the civil suit went through juvenile criminal court.

Mark Kosieradzki, one of the attorneys for the alleged victims, from the Kosieradzki-Smith law firm, said the families have a lot of questions that remain unanswered and hope the lawsuit provides answers.

The main questions the victims' families want answered are the following: How could the alleged abuse gone on four, five or even six months? And why was no one at the facility monitoring these aides?

Jim Carey, the other attorney in the case, from Sieben, Grose, Von Holtum & Carey law firm, said this situation was not just the case of one employee who on one or two occasions engaged in this type of behavior. Instead, he alleged, these nurses aides were going into rooms and locking the doors. There was screaming from the residents, laughing from the aides and videotaping as well.

Kosieradzki said the operator of the local Good Samaritan facility has ample resources available to provide enough people to supervise its aides. The Evangelical Lutheran Good Samaritan Society operates in 23 states and has almost 20,000 patients, with more than $1 billion in assets each year, he said, to support his statement.

The two lawyers said the victims' families hope the lawsuit will raise awareness that this type of nursing home abuse does happen and that hopefully the system will change.

The specifics

The lawsuit accuses the nursing assistants of striking residents' breasts, poking residents' breasts, pinching residents' nipples, inserting fingers in residents' mouths until they screamed, rubbing residents' crotches, inserting a finger into a residents' rectum, exposing their bare buttocks, sitting with their bare buttocks on the lap of a senior resident, spitting on a resident, squirting water at a resident and simulating sexual activity with a resident.

"The Evangelical Lutheran Good Samaritan Society's systemic failure to exercise proper supervision and control over the conduct of its teenage employees resulted in the six-month pattern of abuse of the vulnerable adults at Good Samaritan Society-Albert Lea," the lawsuit states.

It accuses the nursing aides of the following:

• Civil assault and battery

• Intentional infliction of emotional distress

• Failure to report the maltreatment of vulnerable adults

The lawsuit alleges the conduct "was so extreme and outrageous that it passed the boundaries of decency and is utterly intolerable to the civilized community" ... It "was so severe that no reasonable person could be expected to endure it."

The aides had knowledge of the maltreatment and had the duty to report that information to the facility, but they did not properly do so, the lawsuit continued.

"As a result of the failure (of the aides) to report the maltreatment of vulnerable adults at Good Samaritan Society-Albert Lea, including Plaintiffs, such wrongful acts and maltreatment were allowed to continue."

The lawsuit lists six claims against the Evangelical Lutheran Good Samaritan Society:

• Direct liability for negligent management

• Direct liability for negligent supervision

• Direct liability for negligent retention

• Vicarious liability

• Strict liability

• Indemnification

It states the Evangelical Lutheran Good Samaritan Society owed a duty to each resident, to use reasonable care for their protection and well-being, and to fulfill the following responsibilities:

• Duty to not abuse or neglect residents

• Duty to provide the care and services necessary for a resident to attain or maintain the highest practicable physical, mental and psychosocial well-being

• Duty to ensure that direct care staff were competent to care for residents' needs and to perform their assigned duties

• Duty to hire, retain and supervise its employees in a manner that risked the maltreatment to vulnerable adults residing at the nursing home.

• Duty to report maltreatment of vulnerable adults

The lawsuit claims the nursing home "breached the duties it owed to plaintiffs," and breached federal and Minnesota nursing home regulations.

"The Evangelical Lutheran Good Samaritan Society negligently failed to supervise resident services, failed to enforce resident care guidelines and failed to ensure that Good Samaritan Society-Albert Lea's professional and nonprofessional staff exercised reasonable care to protect plaintiffs from harm that was reasonably foreseeable," it states.

The facility "had an absolute duty to protect plaintiffs, to provide them a safe environment, to provide safe services and to report suspected maltreatment," the document continues.

At the end of each claim it says the plaintiffs "have experienced injuries to mind and body, causing them each to experience pain and suffering." The suit asks $50,000 for each claim for each of the plaintiffs, but the lawyers said that amount is arbitrary. It could be higher, depending on what a jury decides.

The lawyers said more suits are likely on the way from relatives of victims who have passed away since the time the acts reportedly happened between January 2008 and May 2008.

The incidents surfaced in May of 2008 and were made public in August of 2008 after the release of a Minnesota Department of Health report that concluded four teenagers were involved in verbal, sexual and emotional abuse of 15 residents at the nursing home.

Good Samaritan Society spokesman Mark Dickerson told the Tribune this morning he heard the lawsuit was filed but has not seen it yet.

He did, however, point out that the state did not cite the nursing home from the incidents and essentially exonerated the facility.

Broitzman and Larson face 21 adult criminal charges in Freeborn County District Court regarding the same allegations.

Carey said the lawsuit did not come about because of dissatisfaction with what has taken place thus far with the criminal side of the case.

He said Freeborn County Attorney Craig Nelson has done the best job he can with what laws are available to him.

Continue reading "Alleged Victims File Suit for Elder Abuse" »

State Sen. Edith Prague said she will re-introduce a bill this year that would make it easier to hold the owners of nursing homes criminally responsible for abuse and neglect of patients in their facilities.

"You can't sue the state, but the nursing home owners who cut back on staffing I feel should be held responsible," she said. The bill passed the state Senate last year, but died in the House.

Prague said a public hearing will be held in front of the Select Committee on Aging on Feb. 16 in the Legislative Office Building in Hartford. The time and room have not been set yet.

Stretched thin

Chris Godialis, supervisory assistant state's attorney and director of the Medicaid fraud control unit, said his office is responsible for policing all the fraud, abuse and neglect in Medicaid cases in Connecticut; he has four investigators.

"If I had 14 people, we'd have more cases, believe me," he said.

At any given time, the office handles an average of about 75 active cases.

Prague's bill would require the Department of Public Health to include a notice in nursing home applications telling owners they could be held criminally accountable for abuse and neglect of residents by their employees.

Godialis said one issue is that many nursing homes in Connecticut are owned by people who live outside the state and believe they can't be responsible for neglect if they don't see it or participate in it.

They can, he said. But it would help in prosecuting a case to have a notice such as the one the bill proposes, showing that nursing home owners were warned.

The bill also would require criminal background checks of nurses who care for people in their homes, he said.

Kyle Wininger, whose father, Robert Wininger, died with gangrene in both his legs after staying at Haven Health Center of Norwich, said she would support the bill.

Wrongful death suit

She said she "would hope that it would lead to some self-policing on the part of owners" of nursing homes. The Winingers filed a wrongful death lawsuit against the doctors responsible for Robert Wininger's care. The suit also names Public Health Commissioner J. Robert Galvin and Haven CEO Raymond Termini as defendants.

Philip Anthony, Griswold's first selectman, whose mother was a resident of Haven Health Center of Jewett City, said holding nursing home owners accountable is necessary.

Public policy should also make state agencies liable for failing to correct violations they discover in nursing homes, he said.

Continue reading "State Senator To Re-Introduce Elder Abuse Legislation to Make Owners of Nursing Homes Criminally Responsible for Abuse and Neglect" »

Investment News reported on 1/4/10 that there are many claims of financial elder abuse in stockbroker fraud arbitrations, but that the Financial Industry Regulatory Authority (FINRA) rarely cites the abuse when handing out awards. Recently, however, FINRA granted two awards to senior citizens who claimed to have been defrauded by brokers indicates California Financial Elder Abuse Attorney Steven C. Peck.

One award went to a 95-year-old investor who accused StockCross Financial Services Inc. and two of its brokers of misconduct and self-dealing. According to the arbitration, which was filed in March 2009, the brokers recommended unsuitable and risky investments and put the elder's home at risk. They then allegedly dropped him as a client after bilking him of all his assets, including his cash reserves, insurance money and home equity states Los Angeles Elder Abuse Lawyer Steven C. Peck.

Because the arbitration was filed in California, the plaintiff, David Wolfson, was entitled to treble damages. Wolfson won a total of $1.6 million, including $320,000 in compensatory damages, $960,000 in damages for elder abuse, $234,000 in legal fees and an additional $83,000 in other fees. StockCross was also ordered to pay $10,000 for not following discovery orders.

StockCross has said that it will fight the decision and will file a motion to vacate. However, FINRA awards are difficult to overturn.

Earlier in 2009, FINRA announced that it was permanently barring a former New York broker from the securities industry for defrauding a senior citizen out of more than $500,000. The 90-year-old investor died before his daughter brought the broker's activities to FINRA's attention.

According to FINRA, the customer invested approximately $500,000 between 2004 and 2006 in a speculative, development-stage company that did not have publicly available financial information. The financial advisor knew this information, but recommended the company to his client anyhow. Furthermore, FINRA found that the broker sold those securities without the knowledge of the two brokerage firms with which he was registered.

The client reportedly paid between $3 and $4 for stock in the company, although there was no reasonable grounds for valuing the stock at those prices. The broker made approximately $76,000 in commissions for the sale of those stocks.

"[The broker] was found to have effected unsuitable investments for the customer given the customer's age and financial condition," FINRA wrote.

The stockbroker neither denied nor confirmed any wrongdoing in the situation.

Continue reading "Financial Elder Abuse Prevelant in Stockbroker Arbitrations" »

Most of the nursing home cases we look at are negligence cases... someone, a doctor or a nurse, fails to provide a level of care they are required to by the standards of medicine.

Occasionally, we will get a case wherein the nursing home staff actually abused a patient. Over medication cases falls into this category.

Recently there was was a Congressional hearing about Johnson & Johnson giving a huge nursing home chain kick backs when their physicians prescribed a medication for Schizophrenia .

Hmm, I wondered to myself. Is Schizophrenia prevalent in America's nursing home such that these doctors were doing the right thing states California Nursing Home Abuse attorney Steven C. Peck.

The answer is simply, NO.

According to Schizophrenia.com, about 10% of people with schizophrenia live in nursing homes. Elderly persons with the disease, have the least likely chance of needing emergency care for related symptoms. If 2.2 Million people have it in the US, and 10% of them live in nursing home, then 220,000 people in nursing homes (approximately) may have the disease.

So how frequently were the doctors prescribing Risperdal (which is not specifically approved to treat problems in elderly people with dementia by the FDA?)

The numbers are not easily calculated, but the nursing home purchases of Johnson & Johnson medications nearly tripled to more than $280 million, from about $100 million from 1999 to 2004.

That's $180 million dollars worth of medication that may or may not have been suitable for a patient. That is medicine being driven by profits and kick backs, not patient needs. That is abuse indicates California Elder Abuse attorney Steven C. Peck.

If you are fearful that your loved one was over medicated in a nursing home, and that the over medication may have caused problems breathing, falls, etc., do not wait, but have the case investigated immediately.

The only way we can prevent doctors from doing this, is to hold them and the nursing home chains, accountable. Contact Steven Peck's Premier legal to talk to an experienced elder abuse and nursing home neglect attorney toll free at 1.866.999.9085 and visit us on-line at www.premierlegal.org.

Napa County leaders are moving toward passing a law requiring that privately hired caregivers working in the county undergo criminal background checks says California Elder law Attorney Steven C. Peck.

The effort comes after years of lobbying by elder advocates concerned about the vulnerability of seniors with workers in their homes. While registered nurses must undergo background checks, caregivers do not indicates California Elder Abuse Attorney Peck.

The goal, as Napa County District Attorney Gary Lieberstein told the American Canyon City Council earlier this month, is preventing elder abuse. "We want to stop this before it starts," Lieberstein said.

Lieberstein told the council that there is no barrier to parolees becoming caregivers, and said that even when a woman agrees to let a grandchild care for her in exchange for room-and-board or wages, she may not know if the caregiver has a criminal history.

"We think she has the right to know," Lieberstein said.

Jane Hinshaw, an investigator with the District Attorney's Office, said elder abuse cases are particularly difficult to investigate. Oftentimes elder abuse comes in the form of theft or taking financial advantage of seniors. Physical evidence is not always available, and victims are reluctant to testify or even acknowledge the crimes.

"The biggest problem that we have with elder abuse is that it's underreported," Hinshaw said.

Similar measures passed at the state level and signed by the governor have not been enforced, local officials say, because the agencies charged with implementing the measures have not formally drafted or imposed the regulations states Steven C. Peck a Los Angeles Elder Abuse attorney who can be contacted toll free at 1.866.999.9085 or on-line at www.premierlegal.org.

According to the National Center on Elder Abuse, elder abuse can take many forms.

•Physical abuse: using physical force to injure or threaten a vulnerable senior.
•Emotional abuse: verbal assaults, threats, emotional isolation or rejection, demeaning acts or statements causing mental anguish or distress to an elder.
•Sexual abuse: sexual contact with a vulnerable senior, including those unable to grant consent. The contact can be the result of force, deception, threats or other coercion.
•Financial exploitation: includes theft and fraud, the misuse of authority, exploiting undue influence over a vulnerable person in order to gain control of the elder's money or property.
•Neglect: the failure or refusal of a caregiver to provide for a vulnerable senior's physical needs, emotional needs or safety.
•Abandonment: the desertion by a caregiver of a frail or otherwise vulnerable elder.
•Self-neglect: when a senior is unable to understand the consequences of their own actions or inaction, which can or does lead to endangerment or harm.
Elder Abuse in Nursing Homes

In too many cases, elder abuse takes place in nursing homes. The National Center on Elder Abuse estimates at least one in 20 nursing home residents has been victimized by abuse or neglect.

According to the best research on the topic, elder abuse is widespread. An estimated one to two million Americans aged 65 years or older has been injured, exploited or otherwise harmed by someone they counted on for care or safety.

Continue reading "Elder Abuse" »

California Elder Abuse Lawyer Steven C. Peck states " the following items are indicative of financial elder abuse and should be brought to the attention of the local authorities or an expereinced elder abuse attorney immediately":

F1
Senior reports being a victim of financial exploitation

F2
Living Will or Living Trust with suspect as executor/trustee

F3
Signatures on some documents unlike victim's

F4
Victim's signature on documents that were signed/dated when victim was unable to write

F5
Victim coerced into signing a contract, will, etc

F6
Victim's signature forged on documents; inancial transaction documents

F7
Disappearance of jewelry, large ticket items, or antiques

F8
Victim's signature forged on documents transferring title(s) to real or personal property/possessions

F9
Victim cannot explain or understand documents created for victim to sign

F10
Abrupt changes in a will or other financial documents

F11
Recent actions (granting Power of Attorney or changing/creating a will) when the victim is not capable of making informed decisions

F12
Missing funds or personal belongings

F13
Misuse of money or possessions

F14
Improper actions taken under POA/conservatorship/guardianship

F15
Numerous unpaid bills/overdue rent when a surrogate has been delegated responsibility to ensure payment

F16
Checks cashed or ATM withdrawals made without authorization/permission

F17
Sudden or unusual banking activity, including switching banks, adding names to account, large withdrawals (especially if made by person accompanying victim), ATM activity by a homebound victim

F18
Victim no longer receives bank statements

F19
Recent acquaintances declared great affection for the victim and then isolated the victim from friends and/or family

F20
Recent acquaintance promised life-long care in exchange for deeding property and/or assigning assets to the acquaintance

F21
Sudden appearance of previously uninvolved relatives claiming rights to manage elder's affairs and possessions

F22
Unexplained/sudden transfer of assets to a relative (especially recently appearing relative) or someone outside the family

F23
Family member or caretaker provides services that are unnecessary

F24
Person other than a caregiver exercises control over victim by isolating victim from friends and family

F25
Victim's living situation and/or level of care not commensurate with available financial resources

F26
Unusual concern by caregiver that an excessive amount of money is being expended on the care of the victim

F27
Implausible explanation for lack of amenities (TV, personal grooming items, appropriate clothing, etc) that the estate can well afford.

Continue reading "The Financial Elder Abuse Checklist: What To Look For" »

Key terms
Overall rating One (worst) to five (best) stars, determined by the federal Centers for Medicare and Medicaid Services based on data in three elements: health inspections, nurse staffing, and measures of quality of care.
Total stars One (worst) to 15 (best). CMS gives homes one to five stars in each of the three elements above. The total of all three elements is part of the U.S. News rankings process. The rest involves star ratings in the individual categories.
Health inspections Conducted by state inspectors at least every 15 months to determine compliance with Medicare and Medicaid standards for food safety, hiring practices, and other aspects of running a nursing home. Homes get one to five stars based on the three most recent regular inspections plus any complaint-related inspections in the past three years.
Nurse staffing Homes get one to five stars based on average time per patient spent by registered nurses, licensed practical nurses, licensed vocational nurses, and certified nursing assistants. Calculation reflects hours worked during two-week period before most-recent regular health inspection divided by number of residents, adjusted by residents' needs and health status.
Quality measures Homes get one to five stars depending on the most recent three quarters of data reported by homes on percentages of residents who received certain care, such as flu vaccinations, and who had care-related problems such as pain, bedsores, or urinary tract infections. Nineteen measures are displayed. Star ratings were determined by 10 with especially high reliability.
Individual nursing home details
Medicare/Medicaid participation Most nursing homes accept Medicare, which pays all or part of the cost of a stay following hospitalization of at least three days; coverage is limited to 100 days per hospitalization. Medicaid covers a stay of any length for individuals who meet income requirements and are ineligible for or have exhausted their Medicare benefits.
Number of beds How many beds are certified for Medicare and/or Medicaid residents. Private-pay beds are not included.
Ownership Nursing homes can be owned by for-profit corporations, nonprofit groups, religious bodies, and other types of organizations.
Initial certification Date home was certified as meeting Medicare or Medicaid requirements. Date when state licensed home to operate is different.
Continuing-care retirement community Provides spectrum of care that changes over time according to resident's needs, from independent apartment living to assisted living to full-time nursing-home care. Generally costly, with a large upfront payment in addition to monthly fees.
Part of a chain Two or more homes under one owner or operator.
Special-Focus Facility (SFF) A nursing home with a persistently bad or erratic history of care. It will be monitored and reinspected until it either has improved enough to be taken off the SFF list or it loses its Medicare or Medicaid certification.
Health inspection details
Health inspections Conducted by state inspectors at least every 15 months to determine compliance with Medicare and Medicaid standards for food safety, hiring practices, and other aspects of running a nursing home. Homes get one to five stars based on the three most recent regular inspections plus any complaint-related inspections in the past three years.
Health deficiencies Specific health or safety requirements the nursing home failed to meet in an inspection.
Complaint investigations Conducted based on complaint from family, friends, or others to state survey agency.
Inspection date When regular or complaint-related inspection was conducted.
Severity of health deficiency Indicates degree of seriousness. 1=did not harm but posed a threat of minor harm; 2=did not harm but posed a threat of more than minor harm; 3=caused harm but did not immediately put residents in jeopardy; 4=immediately threatened health or safety.
Scope of health deficiency Relative number of residents who were or could have been affected. 1=few or none; 2=some; 3=many.
Nurse staffing details
Nurse staffing Homes get one to five stars based on average time per patient spent by registered nurses, licensed practical nurses, licensed vocational nurses, and certified nursing assistants. Calculation reflects hours worked during two-week period before most-recent regular health inspection divided by number of residents, adjusted by residents' needs and health status.
Hours per resident (all nurses) Average care time per resident per day spent by registered nurses, licensed practical nurses, and licensed vocational nurses, reflecting hours worked during two weeks before most-recent regular health inspection. Adjusted by residents' health status and condition.
Hours per resident (RNs only) Average care time per resident per day spent by registered nurses, reflecting hours worked during two weeks before most-recent regular health inspection. Adjusted by residents' health status and condition.
Hours per resident (LPNs, LVNs) Average care time per resident per day spent by licensed practical nurses and licensed vocational nurses, reflecting hours worked during two weeks before most-recent regular health inspection. Adjusted by residents' health status and condition.
Hours per resident (CNAs) Average care time per resident per day spent by certified nurse assistants, reflecting hours worked during two weeks before most-recent regular health inspection. Adjusted by residents' health status and condition.
Quality measure details
Quality measures Homes get one to five stars depending on the most recent three quarters of data reported by homes on percentages of residents who received certain care, such as flu vaccinations, and who had care-related problems such as pain, bedsores, and urinary tract infections. Ten of the 19 displayed measures determined the star rating. Indicates adequacy of care such as percentages of residents with pain, bedsores, or urinary tract infections. From data nursing homes are required to collect and report for each resident. The star rating is based on 10 of the 19 measures shown.
Long-stay measures Apply to residents who are in a home for longer than a few days or weeks.
Short-stay measures Apply to residents who are in a home for a brief period to recuperate or to receive rehabilitative services.
Fire safety details
Fire safety Medicare- and Medicaid-certified nursing homes must meet safety standards set by the National Fire Protection Agency.
Fire safety deficiencies Ways in which nursing home failed one or more NFPA standards in the most recent inspection.
Severity of fire deficiency Indicates seriousness of failure. 1=did not harm but posed a threat of minor harm; 2=did not harm but posed a threat of more than minor harm; 3=caused harm but did not immediately put residents in jeopardy; 4=immediately jeopardized health or safety.
Scope of fire deficiency Relative number of residents who were or could have been affected. 1=few or none; 2=some; 3=many.

Continue reading "Key Elements Used In Determining the Quality of Care in Nursing Homes: What to Look For" »

On a given day, 1.5 million people are living in the nation's 16,000-plus nursing homes, and in a typical year more than 3.2 million Americans will spend at least some time in one. That's a lot of families who need to find good care, which is why U.S. News ranks and displays data about nearly every one and updates the information every quarter. The Honor Roll lists the 11 homes that have received perfect ratings for four consecutive quarter says California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

The U.S. News rankings rely on Nursing Home Compare, a program run by the federal Centers for Medicare and Medicaid Services. CMS analyzes information on all homes enrolled in Medicare or Medicaid other than about 150 too new to provide data and gives them ratings of one to five stars overall. The homes also receive ratings of one to five stars in each of three areas: health inspections, nurse staffing, and measures of care advises California Elder Law Lawyer Peck.

At Nursing Home Compare, you can search for a specific home or for all homes in a particular state or within a certain distance of your city or ZIP code. But you can't assume that all five-star homes, or those with three or four stars, are of the same quality. There are so many homes in each rating--1,855 in the five-star and 3,661 in the four-star categories alone--that the range of performance is bound to be very wide. Nor can search terms be combined if, say, you want only five-star homes within 50 miles of a specific city indicates California attorney Steven C. Peck.

America's Best Nursing Homes addresses these and other issues. Homes are presented in tiers within each star category, based on their total stars in all three of the major areas. The topmost tier, for example, consists only of five-star homes that got 15 stars. The next tier down is five-star homes with 14 total stars, and so on. Within each tier, homes are listed alphabetically. If you're hunting for a home by state, region, city, or ZIP code and turn up too many to be readily managed, search terms can be combined in order to narrow the results to homes that have a religious affiliation, for example, or that accept Medicare residents. Or you can launch a multipronged search, perhaps for religiously affiliated five-star Medicare homes within 50 miles of a particular city.

All of the homes in the 50 states and the District of Columbia that are included in Nursing Home Compare are in the Best Nursing Home rankings; CMS cannot evaluate a small number that take only private-pay residents. Here are more details about the measures that go into the CMS ratings.

Health inspections. Because almost all nursing homes accept Medicare or Medicaid residents, they are regulated by the federal government as well as by the states in which they operate. State survey teams conduct health inspections on behalf of CMS about every 12 to 15 months. They also investigate health-related complaints from residents, their families, and other members of the public. "Health" is broadly defined, as is evident in the 180-some items on the checklist. Besides such matters as safety of food preparation and adequacy of infection control, the list covers such issues as medication management, residents' rights and quality of life, and proper skin care. A home's rating is based on the number of deficiencies, their seriousness, and their scope, meaning the relative number of residents who were or could have been affected. Deficiencies are counted that were identified during the three most recent health inspections and in investigations of public complaints in that time frame. State inspectors also check for compliance with fire safety rules, although their findings do not factor into the CMS ratings. Best Nursing Homes displays the full range of health and fire inspection results online.

Nurse staffing. Even the best nursing care is not enough if there are too few nurses to spend much time with residents, so CMS determines average nursing time per patient per day. Homes report the average number of registered nurses, licensed practical nurses, licensed vocational nurses, and certified nurse aides who were on the payroll (agency temps are not counted) during the two weeks prior to the most recent health inspection and their number of hours worked. The information is compared with the average number of residents during the same period and crunched to determine the average number of minutes of nursing time residents got per day. A home had to provide at least 33 minutes per patient to receive five stars in the latest ratings. The actual numbers appear in the rankings online.

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Continue reading "Nursing Home Data and Rankings Affect Nursing Home Residents" »

Financial Elder Abuse scams are on the rise.

Jo Rivers, 80, feels embarrassed and angry that she got scammed out of $2,100.

This elder says a caller recently convinced her to wire money to Ohio..

"They called me on the phone and they wanted me to send money to my son," she said. But Hall's son wasn't in Ohio. The senior says she got confused and wired the money anyway.

"Oh I was very embarrassed and stupid," she said.

But she's not alone. The ailing economy has desperate people looking for easy targets says California Financial Elder Abuse Attorney Steven C. Peck.

"They (seniors) come from a trusting generation and a lot of people take advantage of that," says Peck.

The Department of Consumer Affairs is teaming up with the Contractors State License Board to host "Senior Scam Stopper Workshops" across the state.

Never give out personal information over the phone unless they initiate the call. And if you're hiring a contractor, make sure they're licensed says California Elder Law Attorney Steven C. Peck.

Popular scams for instance, include people calling seniors telling them they've missed jury duty and must pay money or turn over personal information to avoid going to jail.

Many California seniors have also been approached by scammers in grocery store parking lots.

"Somebody will come up and whack their hand on the side of the car and then tell the senior you hit my car,"

That's what happened to 81-year-old Nell Adams, who agreed to go to the bank and pay a couple $300.

"They wanted money and dumb me, I was willing to pay it," Adams said.

Fortunately someone witnessed what the couple was pulling and scared them off. Consumer advocates say it's important seniors are aware of the scams and take steps to protect themselves.

"My hope is to educate people so they're proactive and identify these frauds and scams and don't get taken" says Peck.

Continue reading "Financial Elder Abuse Scams Are On The Rise" »

A Fort Worth nursing home company left some residents' wounds untreated for so long that maggots infested them or amputations were required . At times, its staff didn't bathe, adequately feed or provide toileting for people. And it cheated Medicare, the U.S. attorney's office said.

Cathedral Rock, at 306 W. 7th Street, and its founder will pay the government more than $1.6 million in criminal and civil penalties, but otherwise won't be punished. Despite an admission of defrauding Medicare, the company will apparently continue to receive taxpayer healthcare payments.

The lawsuit and fraud concerned five homes in Missouri. Prosecutors said Thursday that company founder C. Kent Harrington, 60, of Fort Worth, also entered into a criminal deferred prosecution agreement for a two-year period.

Harrington, who earned an MBA from TCU in 1985, was charged with defrauding Medicare and Medicaid by submitting false statements and claims for the "the grossly deficient care" at nursing homes, according to the news release.

Cathedral, which says on its Web site that it puts "Integrity first, service above self and excellence in everything we do," also operates five facilities in Texas, one of which was found in July to have put residents in immediate jeopardy of harm. The problem was corrected, state officials said.

Michael S. Evans, Cathedral's executive vice president, spoke on behalf of Harrington and the company. He said he didn't know the source of the allegations of maggot-infested pressure sores and related amputated feet and legs says California Elder Abuse Attorney Steven C. Peck.

"On this issue with the maggots, that I think was something that was alleged against the building during a prior operator's tenure. ... I wasn't familiar with that piece of it," he said. Cathedral has leased the Missouri homes since July 2001. In a statement, the company said the case was based on allegations made by former employees 6½ years ago.

Evans also said the company was bound by an agreement with the government to remain silent. In plea agreements, the company admitted:

■ Staffing at nursing homes was, at times, insufficient to provide adequate care.

■ Wound care was sometimes not provided.

■ Residents often did not receive their medication.

■ Medical records were falsified, including during a "charting party" to make it appear all medications had been properly given by filling in records.

■ Fraudulent claims submitted to Medicare and Missouri Medicaid were for services that weren't provided or were worthless.

Cathedral and Harrington are not listed as being excluded from receiving Medicare funding, according to online U.S. Department of Health and Human Services records. Instead the company has a "corporate integrity agreement" that effectively gives it a second chance to play by the rules. The company must adhere to federal regulations for five years.

If Harrington abides by the conditions of his deferred prosecution agreement, the felony complaint against him will be dismissed.

"The government recognized it was in the best interest of justice that Cathedral Rock be allowed to continue to implement and maintain a rigorous compliance and ethics program," the company statement said, adding that it appreciates recognition "of the contribution that the company.

Continue reading " Nursing Home Severely Elderly Abuses its Patients" »

The elderly will outnumber children for the first time in 2045, ratcheting demand on nursing homes and increasing the burden on working-age people to support retirees, a United Nations report found.

The proportion of the world's population older than 60 years will reach 22 percent over the next four decades from 11 percent in 2009 and 8 percent in 1950, the UN's Department of Economic and Social Affairs said in the report, titled World Population Ageing 2009.

The ranks of the elderly are expanding 2.6 percent a year, three times faster than humanity as a whole, mostly because people are living longer and having fewer children. The trend will affect economic growth, savings, investment, consumption, labor markets, pensions and taxation, the UN found. It will also influence living arrangements, housing demand, migration trends and the need for health-care services.

"As children account for a declining proportion of the population, there may be a reduction in the number of schools just as the increasing share of the older population begins to require more long-term care facilities, says California Elder Law Attorney Steven C. Peck.

The number of people older than 60 surpassed 700 million worldwide last year and is projected to swell to 2 billion by 2050, or triple the level in 2000. In most countries, the population over 80 is growing faster than any other age group and will continue growing rapidly until at least 2050, indicating "a growing demand for long-term care," indicates California Financial Abuse attorney Steven C. Peck.

Today, the median age for the world is 28 years. The north central African nation of Niger has the youngest population with a median age of 15; Japan has the oldest, with a median age of 44, according to the report. Worldwide, the median age will likely increase by 10 years over the next four decades.

Contact Steven Peck's Premier Legal toll free to talk to an experienced California Elder Law and Neglect Layer toll free at 1.866.999.9085 and visit us on-line at www.premierlegal.org.

Los Angeles County Supervisor Michael Antonovich is hailing the signing of Assembly Bill 215, which will require that state nursing homes post assigned grades reflecting their quality ratings. The nursing home grading system was kicked off by Antonovich at the LA County level, and recent legislation by Santa Clarita's Assemblyman Cameron Smyth and Assemblyman Mike Feuer has made it law, beginning January 1, 2011.

"In reflecting on this past year, one bright light that shines across our County and State and will enhance the quality of care for our senior citizens was the state law I initiated requiring nursing homes to publicly display their five-star rating issued by the Federal Government's Centers for Medicare and Medicaid Service," said Supervisor Michael D. Antonovich, who also led the charge in establishing the County's successful restaurant grading system in 1997. "This posting system provides vital information for families to make informed decisions about the care for their loved ones and provides incentives for nursing homes operators to establish and maintain high-quality standards of care and compliance."

The rating system covers quality of medical care, staffing levels, food services, sanitation, bedsore mitigation and the results of licensing inspections. The system designates five stars for the highest rated facilities, down to one star for the poorest.

The ratings have already been designated, however until this law goes into effect, nursing homes will not be required to post them says California Elder Abuse and Neglect Attorney Steven C. Peck who can be contacted toll free at 1.866.999.9085 or on-line at www.premierlegal.org.

While the nursing home grade posting system program does not go into effect until 2011, Antonovich has made the Nursing Home Compare Tool accessible now at www.antonovich.com.