California Elder Law Attorney Blog

Northern Nevada nursing homes are regularly inspected by state agencies and cited for violations of care standards, but fines and other serious sanctions are rarely imposed-- even when a patient dies as a result of neglect or mistreatment, according to a Reno Gazette-Journal investigation into government inspections of nursing homes.

Some states, including California and Washington, can fine nursing homes for violating regulations, but Nevada law mirrors federal Medicare procedures. Medicare's "nonpunitive" system allows nursing homes to correct problems found during inspections instead of being fined for violations.

In Nevada, nursing homes can be cited for the same kinds of violations year after year. It's only when they fail to correct the problems after multiple inspections that fines are levied. Eight Northern Nevada nursing homes have been fined in the past three years.

Examples the Reno Gazette-Journal found of deficient care in Northern Nevada nursing homes during the past three years that didn't result in fines or serious sanctions included:

» A patient who had been left without care for 81 hours became severely dehydrated and died after being rushed to a hospital.

» Physical abuse by nursing home staff members against patients.

» Many documented cases of avoidable bedsores caused by patients left in the same position for many hours. In some cases, severe bedsores went unnoticed by staff members, and in other cases, infections went untreated for long periods.

» Patients given the wrong drugs, and some who overdosed on the medications.

"It's very sad we're doing this to our elderly people," said LaVonne Schfler of Reno, whose mother has spent time in nursing homes for rehabilitation and who does volunteer work with the Special Advocates for Elders program at the University of Nevada, Reno.

"They spend their lives working hard, contributing to society, and then when they can't care for themselves, their children have a choice between their survival or their parents' survival. (The children) can't do 24-hour care and work at the same time, so they wind up in nursing homes where they may be mistreated or neglected. It's not right."

Continue reading "Nevada Nursing Homes Are Regularly Inspected But Fines and Sanctions For Violations of Care Standards Are Rarely Imposed Says California Nursing Home Abuse and Neglect Attorney Steven C. Peck" »

Preventing Pressure Sores:

Bedsores can appear on any part of the body. In nursing homes the most commonly observed decubitus ulcers are on the back, bottom, and heels. To combat bedsores, skilled nursing facilities have instated positioning policies to help reduce and prevent pressure sores in residents. Residents that are unable to position themselves are re-positioned on a timetable that reduces pressure on parts of the body in contact with pressure causing materials says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven C. Peck.

Decubitus ulcers are categorized in stages:

Stage 1 - The skin in the area may appear pink, grey (ashen), swollen, and sensitive to the touch. This stage is treated by creams and protective barriers such as foam pads or booties for the heels.

Stage 2 - Skin is red, swollen, and may have one or more blisters. The treatment for this stage is similar to stage 1. A positioning schedule may begin now if barriers have not prevented further skin damage.

Stage 3 - Skin has broken and a wound resembling a crater is visible. The wound extends beyond the surface and deeper into skin layers. Treatment is more aggressive. Barriers, positioning schedules, removal of tissue that may be dying.

Stage 4 - The wound extends very deep, beyond the skin and into the fat, muscle, and in severe cases- to the bone. Very aggressive treatment. While stage 4 is considered the worst, the degree of wound can vary within the stages. A bedsore can become infected at any stage and in the extreme end of stage 4 the sore may have dead tissue, known as 'going necrotic'.

Treatments:

Decubitus ulcers are treated by aggressive positioning schedules, positioning devices, and barrier methods. Foam pads for wheelchairs, foam heel protectors or 'booties', an hourly re-positioning schedule - side to back to opposite side.

Creams are applied to reduce contact with urine or feces. These creams are very thick and can be hard to spread. They are designed to last much longer than typical 'diaper' creams.

In extreme cases a doctor may remove dead tissue, close the wound, or graft new skin to the area.

Continue reading "Los Angeles Nursing Home Abuse and Neglect Attorney Speaks Out On How to Prevent Bed Sores, Pressure Sores and Decubitus Ulcers" »

Elder abuse is described by the following acts among family and members of the household, any nursing home staff or any individual.

When somebody attempts or causes physical injury to an elder - When the family member or staff of a nursing home try to or is trying to place an elder in terror or alarm of physical harm by torment, threat or harassment - When one is convincing or persuading an elder by strength or intimidation to participate in a certain act from which the elder has the right to withhold - When one meaningfully confines the movements of an elder without his consent - Threatening the elder to a crime of violence

1. Detecting Abuse:

- Burn markings from cigarette - Black eye, lacerations, bruises or cuts that can not be explained - Rope marks, a sign that the elder had been tied or slashed upon - Hair loss, a sign that the elder's hair was pulled - Bodily sores and wounds - Fingernails that are broken - The elder's skin is very poor condition - Fractures of the bone - Bite marks - Eye glasses are broken - Laboratory results are positive of drug overdose - The elder displays a sudden change of behavior - The care giver refuses to allow visitors to see the elder

2. Signs Of Neglect:

- Sores are untreated - Displays significant signs of malnutrition - May show signs of insanity - Lack of personal hygiene care

3. Signs Of Emotional Abuse:

- May display a nervous behavior - Constantly be disturbed or upset - Displays a negative attitude - Always in anxiety - Demonstrate signs of insecurity, such as constant sucking or biting of the fingers

4. Financial Abuse:

- Unknown withdrawal from the elder's account - Unusual ATM withdrawals and switching of accounts - The elder tend to withdraw money often - The elder does not receive his pension or Social Security check from the mail - The elder, without any valid reason, revises his will and changes his beneficiary - The elder unexplainably signs contracts that results to unwanted financial commitment - Signature was forged - The elder has plenty of unpaid bill, despite his assets that can very well cover the bill - Strange credit card charges

5. Signs Of Sexual Abuse:

- Mysterious and unexplained genital infection - Anal or vaginal bleeding that can not be explained - Ripped underwear - The elder may tell someone that she has been sexually abused - Genitals are bruised - The elder may report that her care giver is showing her pornographic materials - The report of the elder that she is forced to touch someone's genitals, observe sexual acts, tell dirty stories and pose nude for a picture

6. How Can You Prevent Abuse To Yourself As An Elder?

- Keep and continue contacts with friends and neighbors - Work out on a buddy system with other elders in the home - Be active socially, do not be in isolation - Protest and speak up if you are not happy or contented with the way your caregiver or other family member treats you. Tell somebody - Request your friends and other relatives to visit you often - Open your mail personally - Never sign anything unless it was reviewed by someone that you trust - Always review your will once in a while - Coordinate so that your pension or Social Security check be deposited directly to your bank account than being sent by mail

7. How Can You Prevent Abuse To Others?

- Pay attention. Be wary and look out for signals that might point towards abuse - Call your loved one as frequently as possible - Visit your loved one often and make certain that she is well taken cared of - Always be open to your loved one, taking the time to always talk to her and assure her that you are there to help and can be trusted - Get permission to periodically look into your loved one's bank accounts as well as credit card statements for unauthorized withdrawals or transactions

Continue reading "San Francsico Nursing Home Abuse and Neglect Attorney Shows You How to Spot Elder Abuse" »

Preliminary results indicate that abuse of the elderly occurs 25 times more often than officially reported, according to the New York State Elder Abuse Prevalence Study of November 16, 2010.

Abuse occurs at a rate of 76 per 1,000 State residents - physical, psychological, financial. Abuse of non-financial mistreatment occurs at the rate of 46.2 per 1,000 State residents.

The highest rate is major financial exploitation (theft of money or property; use of items without permission; impersonation to get access; force or deception to get items such as money, bankcards, accounts, powers of attorney) - 41 per 1,000 surveyed.

The report compared "documented cases" (those referred to agencies like Adult Protective Services) which identified 11,432 victims in 2008; yielding a rate of 3.24 elder abuse victims per 1,000 seniors, against the much higher self-reported number in this study.

The report's numbers show:
- All types of elder abuse - 23.5 unreported cases to every one reported.
- Financial exploitation - 43.9 self-reported cases to every one reported.
- Neglect cases - 57.2 cases unreported for every one reported.

This suggests a significant gap between elder abuse reported and cases referred to formal elder abuse service systems, such as Adult Protective Services (APS).

Overall, the study found elder abuse frequency nearly 24 times greater than the number of cases referred to agencies that assist seniors - social service, law enforcement, legal authorities. An estimated 260,000 older adults in the State have been victims of at least one form of elder abuse since turning 60.

More than Simple Abuse

Most people associate "elder abuse" with a physical act. This study demonstrates that a substantial amount of the abuse is financial exploitation. Seniors often have substantial assets under their control. Americans over the age of 55 control 70 percent of the nation's wealth. MetLife reported that from March 2009 "cases actually reported to authorities represent only the 'tip of the iceberg." This new study confirms the significant underreporting of elder abuse in the State.

One article notes approximately 60 percent of substantiated APS cases of financial abuse involve adult children, compared to 47 percent for all other forms of abuse. Most distressing is the unsavory involvement of family members. Another study found that 16 percent of fraud was committed by a member of the senior's family. Examples include fraudulent transfers of property; transfers of property for less than fair value, or mortgages obtained for cash says Los Angeles Elder Abuse Attorney Steven C. Peck.

Many of the elderly, especially women, may not understand the value of their assets. The Federal Trade Commission found that fraudulent telemarketers direct nearly 80 percent of their calls to seniors.

Other Financial Abuse

The FBI website contains an exhaustive list of reasons why seniors are preyed upon:
- Senior citizens are most likely to have "nest eggs," own their homes, and/or have excellent credit.
- Those raised in the 1930s, '40s and '50s were taught to be polite and trusting. Criminals exploit these traits.
- Older Americans are less likely to report fraud; why, because they may not know where or how to report, are too ashamed, may not realize they were victimized. Seniors may keep these crimes secret out fear of losing their independence.
- Seniors are often poor witnesses - memory may be faulty, a failure to supply detailed information, or the lapse of time until the harm is has been discovered - makes it even more difficult.
- Exploitation in products promising increased cognitive function, virility, physical conditioning, cancer treatment, etc. are commonplace.

Those who exploit the elderly unrelenting in their efforts to steal the financial security that took a lifetime to achieve.

How to Prevent

Prepare. Have a well-planned estate. Make sure the proper legal instruments are in place. Meet with an experienced estate planning attorney. If you suspect abuse to anyone by anyone, report it without delay.

These are real concerns. We are not suggesting that it will happen to you. Merely that the best way to protect yourself and those you love is to be proactive.

What Should You Do

If you suspect this may have occurred, act without delay. Contact an experienced Peck Law Group elder abuse attorney toll free at 1.866.999.9085. We will help you!!!

If you think all nursing homes are pretty much the same, ask the experts at the federal Centers for Medicare and Medicaid Services (CMS). The center uses a five-star rating system to rank facilities certified by both insurance programs.

The ratings factored in three years of health and fire-safety inspection results, substantiated complaints and quality-of-care measures, as well as current staffing levels. They used information that was current as of Jan. 20, 2011 but it may not reflect more recent inspection or survey results of nursing homes in the State of Minnesota area says California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

They ranked each facility by the number of health deficiencies in the most recent inspection cited by CMS.

They also have listed complaints that were substantiated by the Minnesota Office of Health Facility Complaints.

1 Golden LivingCenter - Chateau, Minneapolis, 28 health deficiencies

One substantiated complaint: Six bathrooms were cited with problems, including sticky floors, a soiled wall and black residue on the floor. Investigators noticed urine odor in two bathrooms, which was linked to malfunctioning ventilation systems.

2 Texas Terrace Care Center, St. Louis Park, 20 health deficiencies

Five substantiated complaints: Staff gave up trying to open a door blocked by a nonresponsive resident who had hanged himself. A resident's arm was broken when a worker twisted it. A male worker kissed and molested a female resident. A resident died after staff did not properly react to his low oxygen-saturation rate. Sign-language services were not always provided.

3 Berkshire Residence, Osseo, 16 health deficiencies

Two substantiated complaints: A resident was burned after he lit a cigarette while on supplemental oxygen. A resident was given a double dose of a medication for 13 days.

4 Robbinsdale Rehabilitation and Care Center, Robbinsdale, 12 health deficiencies

Six substantiated complaints: A worker threw a glass of water in a resident's face and swore at her. A resident sustained burns from smoking while on supplemental oxygen. The health care of a resident with behavior issues was neglected. Medications were not given at appropriate times, care plans were not followed and workers were slow to respond to call lights. Social work services were inadequate and care conferences were not timely. Drug disposal was done improperly.

5 Westwood Health Care Center, St. Louis Park, 8 health deficiencies

Three substantiated complaints: A resident received third-degree burns from a hot compress. A male worker kissed and molested a female resident. A resident was found lying under her wheelchair on a concrete landing in a stairwell.

Westwood is one of four Minnesota nursing homes designated as a "special focus facility" by the CMS for having a "history of persistent poor quality of care." The facility has been on the list for 15 months and is subject to more frequent inspections.

The three other homes on the list: Crest View Lutheran Home, Columbia Heights, Willmar Commons Nursing and Rehabilitation, Willmar, and Valley View Manor, Lamberton.

6 Serenity Care Center - Bethesda, South St. Paul, 8 deficiencies

Two substantiated complaints: Staffing and equipment were insufficient and nursing care was inadequate. Staff were not alerted when a resident fell and broke several bones, because the resident was not equipped with a personal safety alarm.

7 Mission Nursing Home, Plymouth, 2 health deficiencies

Two substantiated complaints: A worker forged documents and diverted narcotics for her own use. A worker hit a resident, giving him a cut on his chin.

Before you put your love one in a nursing facility check with your State Department of Health Services if any facility has had complaints and that those complaints have been in fact substantiated.

Continue reading "San Diego Elder Abuse Attorney Steven Peck Comments on The Evaluation of Skilled Nursing Facilities" »

Bedsores fall into one of four stages based on their severity. The National Pressure Ulcer Advisory Panel, a professional organization dedicated to the prevention and treatment of pressure sores, has defined each stage as follows:

* Stage I. A pressure sore begins as a persistent area of red skin that may itch or hurt and feel warm and spongy or firm to the touch. In blacks, Hispanics and other people with darker skin, the mark may appear to have a blue or purple cast, or look flaky or ashen. Stage I wounds are superficial and go away shortly after the pressure is relieved.
* Stage II. At this stage, some skin loss has already occurred -- either in the outermost layer of skin (the epidermis), the skin's deeper layer (the dermis), or in both. The wound is now an open sore that looks like a blister or an abrasion, and the surrounding tissues may show red or purple discoloration.
* Stage III. By the time a pressure ulcer reaches this stage, the damage has extended to the tissue below the skin, creating a deep, crater-like wound.
* Stage IV. This is the most serious and advanced stage. A large-scale loss of skin occurs, along with damage to underlying muscle, bone, and even supporting structures such as tendons and joints.

If you use a wheelchair, you're most likely to develop a pressure sore on:

* Your tailbone or buttocks
* Your shoulder blades and spine
* The backs of your arms and legs where they rest against the chair

When you're bed-bound, pressure sores can occur in any of these areas:

* The back or sides of your head
* The rims of your ears
* Your shoulders or shoulder blades
* Your hipbones, lower back or tailbone
* The backs or sides of your knees, heels, ankles and toes

Continue reading "Los Angeles Bed Sore Litigation Lawyer Talks About Stages and Symptoms of Bed Sores, Pressure Sores and Decubitus Ulcers" »

Below are some of the factors which may cause Nursing Home Abuse and neglect and Elder Abuse indicates Van Nuys, California Nursing Home Abuse and Neglect Attorney Steven C. Peck:

Caregiver Stress:

Working in a nursing home or residential care facility can be extremely stressful. It is a difficult job done well by many special people. The staff may meet frustration with a violent response. The lack of adequate staffing can result in employees being overworked and becoming overly tired and more prone to making mistakes. They may be under considerable stress to meet the needs and demands of too many residents. Inadequate staffing can lead to inappropriate levels of responsibility resulting in neglect.

Inadequate Training of Staff:

Adequate training of employees is essential if they are to deliver care to residents in an efficient and appropriate manner. Lack of training is the source of a large range of potential problems from improper transfers to bathing accidents to choking. Employees should be trained in dealing with problem situations that can lead to abuse.

Inadequate Supervision of Staff:

The facility may have provided training and have preventative programs in place, but their implementation is not monitored by supervisory staff. Part of the role of the supervisory staff is to help aides handle difficult residents. Another role is to ensure that safe procedures are adhered to. Without adequate supervision, aides may use inappropriate measures or techniques to the detriment of patient care.

High Turnover Rates of Staff:

For a variety of reasons, it is difficult to attract and retain qualified employees. Some of the reasons include low wages, lack of qualified applicants and poor screening and hiring practices.

Continue reading "Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck Illustrates Some of the Causes of Elder Abuse" »

Elder abuse in the state of California can be defined as mistreatment of an elder (aged 65 years or older) or dependent adult (between the ages of 18 and 64 with physical or mental limitations) living either within a home or an institution.

Common types of abuse are physical abuse (causing pain or injury), psychological (causing mental anguish), sexual (assault or rape), financial (using property or money without consent), abandonment, neglect (lack of reasonable care), abduction (taking the elder out of the state without consent), isolation (purposely preventing communication and contact) and self-neglect (an elder refusing to care for themselves to the point of harm).

Continue reading "Los Angeles Elder Abuse Attorney Steven Peck Defines Elder Abuse" »

As elders become more physically frail, they're less able to stand up to bullying and or fight back if attacked. They may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them more trying companions for the people who live with them..

Tens of thousands of seniors across the United States are being abused: harmed in some substantial way often people who are directly responsible for their care
More than half a million reports of abuse against elderly Americans reach authorities every year, and millions more cases go unreported.

Where does elder abuse take place?

Elder abuse tends to take place where the senior lives: most often in the home where abusers are apt to be adult children; other family members such as grandchildren; or spouses/partners of elders. Institutional settings especially long-term care facilities can also be sources of elder abuse says San Diego Elder Abuse Attorney Steven C. Peck.

The different types of elder abuse:

Abuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial chicanery. The most common are defined below.

Physical abuse:

Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.
Emotional abuse

In emotional or psychological senior abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress.

Verbal forms of emotional elder abuse include:

* intimidation through yelling or threats
* humiliation and ridicule
* habitual blaming or scapegoating

Nonverbal psychological elder abuse can take the form of:

* ignoring the elderly person
* isolating an elder from friends or activities
* terrorizing or menacing the elderly person

Sexual abuse:

Sexual elder abuse is contact with an elderly person without the elder's consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse.

Neglect or abandonment by caregivers:

Elder neglect, failure to fulfill a care taking obligation, constitutes more than half of all reported cases of elder abuse. It can be active (intentional) or passive (unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does).

Financial exploitation:

This involves unauthorized use of an elderly person's funds or property, either by a caregiver or an outside scam artist.

An unscrupulous caregiver might:

* misuse an elder's personal checks, credit cards, or accounts
* steal cash, income checks, or household goods
* forge the elder's signature
* engage in identity theft

Typical rackets that target elders include:

* Announcements of a "prize" that the elderly person has won but must pay money to claim
* Phony charities
* Investment fraud

Healthcare fraud and abuse:

Carried out by unethical doctors, nurses, hospital personnel, and other professional care providers, examples of healthcare fraud and abuse regarding elders include

* Not providing healthcare, but charging for it
* Overcharging or double-billing for medical care or services
* Getting kickbacks for referrals to other providers or for prescribing certain drugs
* Overmedicating or undermedicating
* Recommending fraudulent remedies for illnesses or other medical conditions
* Medicaid fraud

Continue reading "Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck Talks About Elder Abuse and Neglect Warning Signs, Risk Factors,and Prevention," »

More and more people die of thirst, malnutrition and from the complications of Bed Sores every single day in hospital wards in California and all around the United States says California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

Dehydration contributes to the death of thousands ­hospital patients every year, the latest figures reveal.

Thousands more die malnourished, because of ­infections and as a result of crippling bedsores.

Continue reading "Elderly Patients Die of Dehydration, Malnourishment and Bed Sores Daily In Hospitals all Across the United States " »

The analysis of death certificates of care home residents exposes an appalling record of neglect that will make all decent people angry.

Thousands if not tens of thousands of elderly people die every year in the United States of dehydration, malnutrition,and bedsores also known as pressure sores and decubitus ulcers. MRSA and Clostridium difficile known as "superbugs", that thrive where standards of cleanliness are not maintained. also cause many deaths of nursing home and long term care facility residents says Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck.

Continue reading "Nursing Homes and Long Term Care Facilities Should Not Be A Death Sentence " »

Under federal guidelines, each nursing facility must develop and implement written policies and procedures prohibiting mistreatment, neglect, or abuse of residents. A resident in such a nursing facility is entitled to receive verbal and written notice of the rights and services to which he or she is entitled during his/her stay in the facility. This notice must be give prior to or upon admission, and periodically throughout the resident's stay, in a language the resident understands. The resident must acknowledge his or her receipt of such notice in writing.

* Nursing home residents have the right to see family members, ombudspersons or other resident advocates, physicians, service providers, and representatives of the state and federal government.
* Residents may keep and use their personal possessions and clothing unless doing so would endanger health and safety.
* Residents have the right to apply for and receive Medicare and Medicaid benefits and cannot be asked to leave a home because they receive such benefits.
* A nursing home must treat all individuals the same, regardless of whether they are private payers or Medicare or Medicaid recipients.
* Residents have the right to keep their clinical and personal records confidential.
* Residents are entitled to lists of what services are paid by Medicare and Medicaid and the additional services for which the residents will be charged, plus the fees for those services.
* Nursing home residents have the right to choose their own personal physician.
* Residents have the right to be fully informed about their medical care.
* Residents have the right to participate in the planning of their care and treatment.
* Nursing home residents have the right to refuse treatment.
* Residents have the right to be free from mental and physical abuse.
* Nursing home residents cannot be kept apart from other residents against their will.
* Residents cannot be tied down or given drugs to restrain them if restraint is not necessary to treat their medical symptoms.
* Residents have the right to raise grievances and have them resolved quickly.
* Residents may participate in social, religious, and community activities to the extent that they do not interfere with the rights of other residents.
* Residents cannot be required to deposit their personal funds with the nursing home, and if they request that the home manage their funds, the home must do so according to state and federal record-keeping requirements.
* Residents have the right to privacy, including in their rooms, medical treatment, communications, visits, and meetings with family and resident groups.
* Residents have the right to review their medical records within twenty-four hours of making a request.
* Nursing home residents have the right to review the most recent state inspection report relating to the home.
* Residents must be given notice before their room or roommate is changed, and residents can refuse the transfer if the purpose is to move them from a Medicare bed to a Medicaid bed or vice versa.
* Residents have the right to stay in the nursing home and can only be removed if it is necessary for the resident's welfare, the resident no longer needs the facility's services, it is necessary to prevent harm to the health or safety of others in the facility, the resident fails to pay after reasonable notice, or the facility ceases to operate.
* Nursing home residents and their representatives have the right to thirty days' notice of a proposed transfer or discharge, and they have the right to appeal.
* Before transferring residents for hospitalization or therapy, the nursing home must inform them of the length of time that their beds will be held open for their return, called the "bedhold period."
* Nursing home residents returning from a hospital or therapeutic leave after expiration of the bedhold period have the right to be readmitted as soon as the first semi-private bed becomes available.
* Residents must be informed of their rights upon admission, and must be given their rights in writing if so requested.

Continue reading "Federal Guidelines Determine The Policies Governing Nursing Home Abuse and Neglect States Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck" »

Nursing home abuse lawsuits are getting to be far more regular annually says San Francisco Nursing Home Abuse and Neglect Attorney Steven Peck.

It truly is tough to think that the workers of a nursing home abuse attorney would be negligent towards their elderly patients, however, many health conditions are at-risk of getting overlooked in a very substandard care setting. It is necessary for loved ones of citizens to continue to be alert for any indications that abuse might be occurring. The failure of a nursing home's workers to identify and deal with a affected person suffering from dehydration is a single normal shortcoming. and should be closely monitored.

The staff of a live-in care facility is accountable for making certain that patients obtain sufficient liquid to continue being adequately hydrated. At any age brain injury claim could cause considerable sickness, but dehydration inside the elderly could cause considerably more severe conditions. For minor dehydration, headaches and dizziness may perhaps happen. Increased dehydration may possibly bring a dangerous fluctuation in entire body temperature, a weakened immune program, and dangerously reduced blood strain.

Members of the family and cherished ones might identify the situation by observing that a patient's eyes appear to be sunken, or probably by noticing a slight modify in character. Confusion is usually a signal that a medical injury claims illness is occurring as a result of the lack of needed liquids within the physique.

Although they cannot reverse the sad conditions which have resulted from nursing home abuse claim, a nursing Home abuse and neglect legal professional may well be able to help in holding a negligent / neglectful facility accountable for the harm it has accomplished. If reported, the events at fault could be heavily fined or even drop their license says Van Nuys, California Elder Abuse Attorney Steven Peck.

Continue reading "Dehydration In the Elderly In Long Term Care Facilities Is Very Common Says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck" »

The golden years for many seniors slip away under a dark shadow of financial and physical abuse, most often caused by the hands they trust most to care for them.

It usually happens behind closed doors. It usually goes unreported.

Law enforcement and elder advocates said the rate of elder abuse is growing at an alarming speed as people live longer, baby boomers reach retirement age and the economy remains shaky.

Experts estimate that only one in 13 elder-abuse cases are reported nationwide, based on various surveys and studies says San Diego Elder Abuse Attorney Steven C. Peck.

In San Diego County, the District Attorney's Office has seen the number of elder-abuse prosecutions rise in the past five years -- from 183 cases in 2006 to 238 last year. The county's elder-abuse hotline receives nearly 10,000 calls a year; about 40 percent of them directly involve financial abuse.

Many cases have both financial and physical abuse, said Paul Greenwood, deputy district attorney and head of the office's Elder Abuse Prosecution Unit.

"People are getting more desperate," he said. "They look around and they see who has the money and they target them."

While some agencies have worked to educate the public, cooperate with mandatory reporters such as banks and set up hot lines and other reporting systems, elder-abuse experts and law-enforcement officials remain concerned about a lack of resources.

An addendum to the national Healthcare Reform Act, which Congress approved last year, would provide money for combating elder abuse. But there has been no funding allocation so far.

Nearly 95 percent of seniors live at home and almost all elder abuse occurs there, the majority perpetrated by family members, said Kathleen Quinn, executive director of the Illinois-based National Adult Protective Services Association. "Trusted others" -- such as home health-care workers, neighbors and friends -- make up the next largest group of abusers.

"It's absolutely an enormous problem," Quinn said.

Other cases include abuse in nursing homes, home-improvement scammers preying on seniors, financial planners who fleece older clients, and home-care workers who get paid but do nothing and even steal from their clients.

Home-care workers, who provide nonmedical assistance such as cleaning, bathing and feeding, aren't required to undergo a background check unless they are paid through a government program. Health care companies and agencies, which provide nurses or other licensed personnel, operate under different regulations.

Elder-care advocates and law enforcement authorities said the home-care-worker system needs more oversight.

Home-care workers who are paid through San Diego County's In-Home Supportive Services program do undergo a background check that looks for evidence of child abuse, elder abuse and fraud against a government agency, said Ellen Schmeding, assistant deputy director for the county's office of Aging & Independence Services.

Continue reading "San Diego Elder Abuse Attorney Steven Peck Sees A Significant Rise In Medical, Physical, and Financial Elder Abuse" »

Neglect levels in California's long term care facilities as well as facilities all over the United States are "scandalous". Thousands of residents have died of dehydration, malnutrition, infected bed sores, Clostridium difficile and MRSA says Los Angeles Nursing Home and Neglect Attorney Steven C. Peck.

It is also feared the totals may be higher because care home residents who die in hospital are not included in the statistics.

The fact that people are dying from these sorts of causes is absolutely shocking in the 21st century.

These people in our care homes will have seen a lot in their lifetime. For them to be treated in that way is nothing sort of scandalous.

Figures suggest that more than 20,000 people have to sell their homes in California every year in order pay for residential long term care fees.

While there are excellent homes it is simply unacceptable that people still die undignified deaths from wholly avoidable causes says Van Nuys, California Elder Abuse Attorney Steven Peck.

Continue reading "Los Angeles Elder Abuse Attorney Says Too Many People Are Dying Undignified Death In Long Term Care Facilities" »

The final element to prove in any elder abuse case in the State of California is that a managing agent knew of, ratified, or is personally guilty of the reckless conduct indicates Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck.

In an acute care facility, look to who created the policies and procedures, who was responsible for insuring that the nursing staff knew, understood, and applied the policies and procedures, who decided the staffing levels for the units on which your client was a patient, who trained the staff on the proper use of beds and mattresses, etc.

Helpfully, the only published opinion that discusses the element of managing agent in an elder abuse case is regarding elder abuse in an acute care facility. See Marron, supra, 108 Cal.App. 4th 1049. The court in Marron found that a nursing supervisor in a hospital is a managing agent.

Continue reading "Managing Agent in an Acute Care Facility" »

As in a skilled nursing facility, reckless conduct certainly occurs in the acute care setting and in many of the same ways, such as poor training and understaffing says Van Nuys, California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

Below is a short outline of specific areas of potentially reckless conduct that plaintiffs' attorney should watch for in an elder abuse case against an acute care facility.

Failure to follow policies and procedures:

The policies and procedures from an acute care facility often provide a wealth of information. Make the effort and take the time to fully familiarize yourself with the hospital's and / or skilled nursing facilities policies and procedures regarding patient care, skin care, wound prevention and wound care, lift teams, beds and mattresses, and any other policies which may affect the care that was provided to your client. In depositions, one should ask each nurse, wound nurse, and supervisor about his or her familiarity with the policies and procedures. Look through the medical records carefully. It is quite likely that the care provided to your client grossly failed to meet the hospital's own policies and procedures on numerous occasions and, in fact, the care providers were not even familiar with the policies and procedures. indicates Los Angeles Elder Abuse Lawyer Steven Peck.

Regularly, nurses fail to request a consultation when it was required; Skin assessments are not completed on a regular basis; Wounds are not cared for as required by the policies and procedures; and Charting is wholly inadequate pursuant to the policies. Ask your expert and you may very well learn that had the hospital followed its own policies, the injury most likely would not have occurred. Failure to follow policies and procedures and failure to insure that the nursing staff is familiar with the policies and procedures constitutes recklessness, in that the individuals involved knew that there was a high probability that this conduct would cause harm and knowingly disregarded this risk

Failure to properly train nurses:

The nurses' failure to understand and have knowledge of the hospital's policies and procedures is one example of a failure to properly train the nursing staff. Independent of the policies and procedures, you may also discover that the nurses do not have a complete understanding of skin care and wound prevention. Their provision of care may fall below the standard of care. As in cases against skilled nursing facilities, request and review the in-service training offered by the hospital.

Failure to provide adequate staffing levels:

As in a skilled nursing facility, an acute care facility will also sacrifice adequate staffing levels for budgetary concerns. You may find that your client required three people to turn him, but that it was difficult, if not impossible to find three available people in the ICU to perform this repositioning every two hours. Hospitals also often employ Wound, Ostomy, and Continence nurses ("wound nurse"). While there is no legal staffing requirement for wound nurses, the hospital itself may have budgeted for one or more wound nurses and determined a medical need for one or more wound nurses. Yet, despite this determination, the hospital may fail to staff at this level.

Failure to place patient on the correct bed or mattress and/or False Reliance on a Mattress:

A major, recurring issue in these cases is the bed and/or mattress on which the patient was placed. Certain beds and mattresses are used for lung therapy, others are recommended for pressure-relief and pressure-reduction. Hospitals and their staff often confuse the two. Many of these beds and mattress overlays rotate the patient from side to side. Many nurses mistakenly believe that this constitutes "repositioning" and record such "repositioning" in the medical chart. This is incorrect and illustrates, again, the poor training provided to the nursing staff. Many experts will explain that bed rotation is not a replacement for manual repositioning every two-hours.

Continue reading "Recklessness in an Acute Care Facility" »

As previously noted, a major step in an elder abuse case against an acute care facility is educating the various players that the neglectful acts at issue are custodial in nature, rather than professional says San Franscisco Nursing Home Abuse and Neglect Attorney Steven C. Peck.

Three seminal California cases on custodial neglect provide a strong starting point for this educational process and help dispel the defense argument that the development of a decubitus ulcer, for example, cannot rise to the level of custodial neglect under Welfare and Institutions Code §15610 et seq. In all three cases the courts held that the development of a decubitus ulcer was sufficient to constitute custodial neglect.

For example, the Covenant Care case dealt with the development of a Stage IV pressure ulcer. Plaintiffs in that case alleged that the decedent was left lying in his bed, unattended and unassisted for excessively long periods of time; he developed ulcers on his body that exposed muscle and bone and became septic. (Covenant Care, Inc. v. Superior Court (2004) 32 Cal.4th 771, 772.) The court held that under those facts, the plaintiffs had sufficiently alleged a cause of action under Welfare and Institutions Code §15610 et seq.

In Delaney, plaintiffs alleged that the health care providers allowed the decedent's serious pressure ulcers to occur and worsen. It was also alleged that there were violations of medical monitoring and that plaintiff was not adequately turned and was neglected. (Delaney v. Baker (1999) 20 Cal.4th 23, 27-28.) Based on these allegations, the court stated that there "was substantial evidence that defendant's failed, over an extended period of time, to attend to her advanced bedsores, and otherwise neglected her in such a way to contribute to her pain and suffering and eventual death, which was determined to be reckless, given defendants' knowledge of decedents' deteriorating condition and plaintiff's repeated efforts to intervene in her mother's behalf." (Id. at 41.)

And in another seminal case on elder abuse, Mack v. Soung (2000) 80 Cal.App.4th 966, also involved the development of a decubitus ulcer. In this case as well, the court found that plaintiffs had sufficiently alleged a cause of action for custodial neglect under Welfare and Institutions Code §15610 et seq.

Most often, a decubitus ulcer case against an acute care facility will contain facts that are nearly identical to the facts identified in the above-referenced cases. Though this may seem obvious, point this out to the defense attorneys. Draw the logical conclusion - as in the cases discussed above, the acts and omissions of the defendant hospital, skilled nursing facility, long term care facility, that resulted in the development of decubitus ulcers constitute custodial neglect under Welfare and Institutions Code §15610 et seq.

Continue reading "Elder Abuse Concerns Custodial Neglect That Causes Bed Sores says California Nursing Home Abuse and Neglect Attorney Steven Peck" »

The application of the Elder Abuse Act against acute care facilities fits squarely under the existing case law, statutory language, and jury instructions. Indeed, the Elder Abuse Act itself includes a broad list of facilities to which the Act applies, making no distinction between skilled nursing facilities and acute care facilities. Welfare and Institutions Code Section 15610.17 states in part:
"Care custodian" means an administrator or an employee of any of the following public or private facilities or agencies, or persons providing care or services for elders or dependent adults, including members of the support staff and maintenance staff:

(a) Twenty-four-hour health facilities, as defined in Sections 1250, 1250.2, and 1250.3 of the Health and Safety Code.
Health and Safety Code Section 1250 includes "general acute care hospital," as well as "skilled nursing facility," providing a solid basis for the argument that the Elder Abuse Act applies equally to the acute care setting.
Similarly, the CACI Jury Instructions on Elder Abuse make no distinction between elder abuse in a skilled nursing facility and elder abuse in the acute care setting. Notably, CACI 3103 specifically provides for a cause of action against a health care provider for custodial neglect without regard to the type of facility:

Continue reading "The Elder Abuse Act AppliesTo Long Term Care Facilities says Los Angeles Elder Abuse Attorney Steven C. Peck" »

Physical Abuse

Bed sores, also referred to as pressure ulcers or decubitis ulcers, are one of the strongest signs of neglect and are completely preventable. Typically, bed sores form on areas where the bone comes into close contact with the skin on the heels, elbows, shoulders and back of the head. They can, however, appear any place on the skin subjected to prolonged pressure. The Centers for Disease Control and Prevention note that bed sores are categorized in stages by the depth and severity of the wound:

- Stage 1: The skin is reddened but not an open wound and will not disappear when pressure is relieved
- Stage 2: Some skin loss associated with the wound and may appear as a blister or shallow crater
- Stage 3: A full thickness of skin is lost, exposing the subcutaneous tissues and appearing to form a deep crater
- Stage 4: A full thickness of skin and subcutaneous tissues are lost, exposing muscle or bone

Continue reading "Bedsores, Pressure Sores and Decubitus Ulcers Should Be Avoidable says Los Angeles Nursing Home and Abuse Attorney Steven C. Peck" »

Elder abuse in nursing homes is an unfortunate occurrence. This type of abuse encompasses the physical and mental abuse of individuals who reside in nursing home as well as the neglect of these individuals for the negligent failure to provide medical services says Van Nuys, California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

There are various federal and state laws which are aimed at preventing nursing home and elder abuse. While some of the laws seek to ensure a safe environment by establishing monetary fines for failure to maintain a proper environment, other laws are criminal in nature.

Federal Laws:

1. There is a substantial federal law which attempts to ensure the quality of nursing homes and prevent elderly abuse. The act is known as the Omnibus Budget Reconciliation Act (OBRA) of 1987. In addition, the act is sometimes referred to as the Nursing Home Reform Act. This act contains provisions specifically aimed at nursing homes which participate in Medicare and Medicaid and receive payment from these programs. The act has companion regulations, contained in the Code of Federal Regulations (CFR). These regulations establish the specific duties of a nursing home, which include having adequate staff, developing comprehensive care plans for nursing home residents, assisting with the daily life activities of the residents, taking preventative measures to prevent bed sores and other types of infections, providing appropriate skilled nursing and non-skilled nursing services to residents, giving medications to patients as needed, ensuring patients' privacy and maintaining updated records for each patient.

State Laws:

2. Every state has laws relating to abuse in nursing homes and health care facilities where the elderly reside. These may include statutes which prohibit the use of restraints without an independent medical review of up to two doctors, establish a freedom from physical or mental abuse, as well as the right to be treated with dignity, to be involved in one's own care and care plan, to have regular visiting hours, to receive mail and to manage one's own affairs. There are other types of laws which may apply, but these are the most common provisions. Usually, with these types of state laws, the penalties are civil in nature; in other words, a violation of the law may result in a fine. In California the Nursing Home State laws are encompassed in Title 22 of the California Code of Regulations.

Criminal Laws:

3. Since elder abuse encompasses physical acts and neglect, there are criminal laws which apply to elder abuse. Rape, battery and assault are all covered by criminal law statues of the state in which the nursing home is located. Furthermore, more serious criminal acts, such as manslaughter and murder are all possible charges against individuals who commit crimes against nursing home residents. In California see California Penal Code Section 368.

The federal law discussed above, known as the Omnibus Budget Reconciliation Act of 1987 or the Nursing Home Reform Act, requires that an ombudsman program be maintained by every state. An ombudsman is a person who serves as an advocate for nursing home residents. The person may assist in the disposition of concerns or problems, or intervene to assist in claims of elder abuse. The goal of the program is to ensure that nursing home residents have the ability to receive quality care and ultimately reduce elder abuse.

Continue reading "Federal and State Laws Are Aimed at Preventing Nursing Home Abuse and Neglect Says Van Nuys, California Elder Abuse Attorney Steven C. Peck" »

Most reported nursing home abuse falls into the category of neglect, such as bed sores, pressure sores, decubitus ulcers, or not maintaining proper sanitation. However, there are many other types of nursing home abuse, and the practice is not rare. According to the online Elder and Nursing Home Abuse Legal Guide, experts estimate that for every reported case of nursing abuse, about five more go unreported says Los Angeles Nursing Home Abuse and neglect Attorney Steven C. Peck.
Physical

1. Nursing home employees can physically abuse residents by hitting, kicking, slapping or any other harmful physical action.

Sexual

2. Sexual abuse also occurs, and is identified as any kind of sexual activity that occurs without the consent of the resident.

Punishment

3. Some nursing home employees punish residents in harsh ways, such as isolating them or subjecting them to painful restraints.

Emotional

4. Insulting residents, threatening or frightening them, or depriving them of their belongings, are examples of another type of nursing home abuse, defined as emotional or psychological abuse.

Neglect

5. Neglect is the most common type of abuse, including not maintaining clean living quarters or personal hygiene, not dispensing medication, or depriving residents of food and water, and the negligent failure to provide medical services.

Continue reading "Los Angeles Nursing Home Abuse and Neglect Attorney Steve Peck Comments About Elder Abuse" »

Elder abuse is defined as any form of mistreatment (resulting in injury or loss) against an elderly person. There are several types of elder abuse.

Physical abuse happens when someone uses force to cause bodily injury or pain and includes battery and assault. Improperly restraining or drugging an elderly person is also considered physical abuse.

Sexual abuse occurs when an elderly person is raped or otherwise sexually assaulted without their consent. It can also happen when porn or other sexually explicit materials are shown to elders against their will, or when the elder is forced to watch sex acts between other people.

There are several other ways elders can be abused. For example, elder neglect (failure to attend to physical care needs) can be considered a form of abuse. This can happen intentionally, or because the caregiver is unaware of or in denial about the level of care the elder needs. Neglect happens very often in Skilled Nursing Facilities based upon the negligent failure to provide for a patient's medical needs says San Francisco Nursing Home Abuse and Neglect Attorney Steven C. Peck.

Health care fraud is another form of elder abuse, in which the nursing home charges for services not rendered or overcharges for services performed. This can also happen when elders' meds are stolen or misreported to insurance companies.

It's also important to keep a close eye on your elderly relative's finances during their stay in a nursing facility. Some corrupt nursing homes or employees attempt to financially exploit the elderly. They may steal checks, credit card numbers or even their entire identity for illegal purposes. Nursing home employees also have been known to ingratiate themselves with elderly residents to attempt to be put into their wills or to forge signatures on documents to obtain money, goods or services in the resident's name.

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A recent report issued by the Department of Health and Human Services (DHHS) has found that nearly all nursing homes in the U.S. have received citations for health and safety violations in 2009. The inspector general of DHHS, federal investigators inspected and evaluated complaints from the nation's 15,000 nursing homes.

Of these facilities, roughly 67 percent are "for-profit" homes, 27 percent are nonprofit companies and 6 percent are owned by the government.

The results of this nationwide inspection found that 94 percent of for-profit facilities and 88 percent of nonprofit organizations received citations for non-compliance last year says Los Angeles Nursing Home Abuse and Neglect Attorney Steven C. Peck.

In addition to calculating the percentage of homes violating federal standards, this investigation also looked into the amounts and types of violations occurring at particular homes.

These analyses found that:

• On average, 8 violations occurred at each non-compliant for-profit facility in 2009.
• About 6 violations occurred at each non-compliant nonprofit and government home in 2009.

In most cases, violations cited by federal inspectors consisted of any combination of:

• Infected bed sores
• Malnutrition
• Medication mishaps
• Patient abuse (either psychological or physical)
• Patient neglect

DHHS investigators contend that lack of adequately trained nursing home staff is primarily responsible for such rampant and disturbing nursing home violations. This contention is supported by the fact that independent researchers have found that having a higher ratio of staff to patients typically results in better care for the patients indicates San diego Nursing Home Abuse and neglect lawyer Steven C. Peck.

Medicare Violations at Nursing Homes

Along with finding such inhumane abuses, the DHHS report also uncovered the fact that some nursing homes were guilty of stealing funds from Medicare and Medicaid - as the facilities were billing these programs for services they didn't provide or provided extremely deficiently.

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