California Elder Law Attorney Blog

New Illinois legislation which was approved by both house of the General Assembly, HB1658, amends the Vital Records Act and will require those responsible for filling out the medical certification or cause of death on a death certificate to ensure that more information in listed in those documents. Death certificates must now note if methicillin-resistant staphylococcus aureus (MRSA), clostridium difficile, or similar infections were the cause or a contributing factor in an individual's death says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck.

MRSA commonly affects residents in nursing homes and those in hosptials. All individuals that have open wounds, use invasive medical devices, and have weakened immune systems--like hospital patients and nursing home residents--are at risk of developing these complications. They are also the most likely to be severely harmed by the consequences of those infections, far too often leading to death says California Elder Abuse Attorney Steven Peck

It remains imperative for all those assisting at-risk individuals like nursing home residents to do everything in their power to prevent these infections. Simple steps are often all that is necessary to prevent the spread of these infections, such as ensuring proper hand washing at all times.

Continue reading "The "Real"Cause of Death Should Be Mandated By Law On Death Certificates Indicates California Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Complications of dehydration may occur because of the dehydration, and/or because of the underlying disease or situation that causes the fluid loss.

Kidney failure
Kidney failure is a common occurrence, although if it is due to dehydration and is treated early, it is often reversible. As dehydration progresses, the volume of fluid in the intravascular space decreases, and blood pressure may fall. This can decrease blood flow to vital organs like the kidneys, and like any organ with a decreased blood flow; it has the potential to fail to do its job.

Coma
Decreased blood supply to the brain may cause confusion and even coma. If enough organs begin to malfunction, the body itself may fail, and death can occur.

Shock
When the fluid loss overwhelms the body's ability to compensate, blood flow and oxygen delivery to the body's vital organs become inadequate and cell and organ function can begin to fail.

Heat-related illnesses and associated complications
In heat-related illness, the body's attempt to cool itself by sweating may cause dehydration to the point that muscles may go into spasm (heat cramps). It is often the muscles that are being stressed that will spasm (for example, in people who work outside in a hot environment, arm and leg muscles may spasm from lifting and moving heavy objects or equipment; in athletes, leg muscles may fail from running). As fluid loss increases, the patient may be so dehydrated that there is not enough water to sweat and heat exhaustion or heat stroke may occur. Heat stroke is a true medical emergency and 911 or the Emergency Response System should be activated immediately in this situation.

Electrolyte abnormalities
In dehydration, electrolyte abnormalities may occur since important chemicals (like sodium and potassium) are lost from the body through sweat. For example, patients with profuse diarrhea or vomiting may lose significant amounts of potassium, causing muscle weakness and heart rhythm disturbances. The health care practitioner is often aware of the fluid and electrolyte balance in the dehydrated patient and may decide to monitor electrolyte levels by checking blood tests. Some examples of symptoms caused by abnormal electrolyte levels include muscle weakness due to low potassium, heart rhythm disturbances due to either low or high potassium, and seizures due to low (hyponatremia) or high sodium. In many patients with dehydration, the kidneys are able to compensate and regulate electrolyte levels.

It is reasonable to remember that dehydration does not occur quickly, and sometimes it may take hours to slowly correct the fluid deficit and allow the electrolytes to redistribute themselves appropriately in the different spaces in the body. If rehydration is done too slowly, the patient may remain hypotensive and in shock for too long. If done too quickly, water and electrolyte concentrations within organ cells can be negatively affected, causing cells to swell and eventually die.

Continue reading "What Are The Complications of Dehydration?" »

The elderly man developed an infection and bed sores also known as decubitus ulcers and pressure ulcers in his Hospital after being left in a soiled bed by staff who would not help her use a toilet. or take her to the bathroom. This type of scenario often transpires in long term care facilities says California Elder Abuse Lawyer Steven Peck.

He also went hungry and thirsty and was reduced to saying: "I want to die, I want to die." Horrible despicable treatment.

The problem is with the attitude of nurses who do not want to provide basic support to frail elders who are many times totally dependant on the nurses for help for eating, drinking, washing or going to the bathroom.

Continue reading "Elders Routinely Develop Bed Sores, Decubitus Ulcers and Pressure Sores In Long Term Care Facilities says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Serious personal injury cases routinely occur in Nursing Homes causing wrongful death says Peck Law Group Accident and Injury Lawyer Steven Peck.

Take the example of a recent case that involved a horrific infected bed sore also known as a pressure ulcer and decubitus ulcer, which as a result of the infection caused the elder individual to become septic. A terrible way to die!!

Negligence is a required component of a wrongful death action and a personal injury accident. The outcome of the investigation into this accident will be of great interest to those families who have sustained the loss of a loved one and to those who have been critically injured as a result of the neglect of the skilled nursing facility.

Infections are very common in the setting of long-term care facilities and
represent a major cause of morbidity and mortality among institutionalized
elderly individuals in nursing homes indicates Van Nuys Nursing Home Abuse and Neglect Attorney Steven Peck.

Some characteristics specific for the setting of a nursing home favor the spread of infectious diseases. Residents are clustered in a confined living arrangement and daily activities often take place in groups.

Some residents are cognitively impaired and unable to follow basic hygiene
precautions. Caregivers are often inadequately trained and may have little
knowledge of the fundamental principles of infection control. As a consequence,
adherence to hand washing in particular and other universal precautions
is poor.

Moreover, understaffing is a common problem in nursing homes. Nursing home residents are particularly susceptible to infections because they are physiologically old and often have comorbid underlying diseases that predispose them to site-specific infections. It is often difficult to diagnose infections in the elderly. As a result, the diagnosis and treatment may be delayed. These host and setting related factors facilitate direct or indirect transmission of infectious diseases among the residents in nursing homes.

Continue reading "Dangerous Infections Are Very Common In Nursing Homes Indicates Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck" »

Disability Rights California, a non-profit advocacy organization mandated to advance the human and legal rights of people with disabilities, supports bill, SB 558.

Disability Rights California supports SB 558 because it will help prevent elder and dependent adult abuse. Elder and dependent adult abuse is an epidemic, which often goes unreported and unpunished. When it is reported, procedural delays and unrealistic legal standards make it difficult to prosecute, letting the perpetrators off the hook and allowing them to continue the abuse.

SB 558 will help prevent physical abuse of elderly and dependent adults by providing stricter civil enforcement of the Elder & Dependent Adult Civil Protection Act (EADACPA or the Elder Abuse Act). The current standard of clear and convincing evidence makes it nearly impossible to prosecute these crimes. This bill allows civil cases to be enforced using a preponderance of the evidence standard, a legal standard consistent with financial abuse cases and virtually every other civil cause of action says Los Angeles Elder Abuse Attorney Steven Peck.

With the growing senior population and recent budget cuts, it is more important than ever to prosecute the perpetrators of crimes against elders and dependent adults indicates California Nursing Home Abuse and Neglect Lawyer Steven Peck.

Continue reading "Disability Rights of California Supports SB 558 Because It Will Help Prevent Elder Abuse and Neglect" »

The United States Census Bureau projected in 2000 that California's elderly population will have doubled by 2025 to 6.4 million - a larger growth rate than any other state says Woodland Hills Nursing Home Abuse and Neglect Attorney Steven Peck.

The California State Department of Finance claims that the number of California residents age 85 and older - those who are most likely to need nursing homes --- will nearly double by the year 2030, when the bulk of baby boomers will come of age.

In 2005, the Office of Statewide Health Planning and Development reported that one-fifth of California's nursing facilities did not meet state-mandated requirements for staffing levels.

In 2006, Centers for Medicare and Medicaid Services reported that twice as many of California's 115,000 plus residents are placed in physical restraints as are nationally.

From 2001 to 2005, the California Department of Health Care Services, found that two-thirds of all reported deficiencies caused or could have caused significant harm to one of more residents in nursing homes. More than half of all complaints in nursing homes are related to poor quality of care. Eighteen percent of substantiated complaints were related to mistreatment or abuse.

Together, these staggering statistics and projections illustrate the urgent need to address and remedy the poor quality of care in many of California's skilled nursing facilities says Peck Law Group Elder Abuse Lawyer Steven Peck.

Continue reading "California's Elder Population Will Double by the Year 2025 Says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Nearly one-sixth of U.S. nursing homes are cited for deficiencies in infection control, according to a May study published in the American Journal of Infection Control says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck.

Researchers from the University of Pittsburgh Graduate School of Public Health analyzed records from 2000 to 2007 relating to the certification process nursing homes must accomplish before qualifying for payment from the Centers for Medicare & Medicaid Services.

The study, based on records representing 96% of U.S. nursing homes, found that infection control citations were linked to lower nurse staffing levels (www.ncbi.nlm.nih.gov/pubmed/21531271) . Nursing home infections kill 400,000 patients a year.

Continue reading "Infection Control a Major Problem In United States Nursing Homes Says California Nursing Home Abuse and Neglect Attorney Steven Peck" »

It's a crime that reaches into thousands of homes... maybe yours... and often... people aren't even aware of it.

How bad is elderly abuse? Here are some numbers that demonstrate the problem.

More than 56 thousand Texans who are older than 65 were victims of abuse, neglect or exploitation in 2010.

The five most common forms of elder abuse are neglect, physical, financial, emotional and sexual says San Diego Nursing Home Abuse and Neglect Lawyer Steven Peck.

Watch over your elder parents and friends. Talk to them ask questions, get to them before the abusers do so.

Continue reading "The State of Texas Reports More Than 56 Thousand Elders Were Victims of Abuse, Neglect and / or Exploitation says Los Angeles Elder Abuse Lawyer Steven Peck" »

An understaffed nursing home can be hazardous to your health if you're a resident there. The latest evidence comes from a study conducted by researchers at the University of Pittsburgh's Graduate School of Public Health, published in the May issue of the American Journal of Infection Control (AJIC).

The study found "a strong correlation between low staffing levels and the receipt of an infection control deficiency citation" at nursing homes, according to a news release from the Association of Professionals in Infection Control and Epidemiology, publisher of APIC. And infections are the leading cause of death in nursing homes, according to the release, responsible for nearly 400,000 deaths per year says Nursing Home and Abuse Attorney Peck.

Inadequate staffing levels leave the people who are working with too much to do, and that seems to be what leads to the increase in infections. "With low staffing levels," wrote the authors of the study, "these caregivers are likely hurried and may skimp on infection control measures, such as hand hygiene."

The researchers found the percentage of nursing homes nationally that received deficiency citations for infection control from the Centers for Medicare&Medicaid Services (CMS) was 17.3% in 2007 -- more than one in six. And that percentage was up sharply from 12.9% in 2000. The increase comes as no surprise when you know the study also found a strong correlation between infection citations and nursing homes' for-profit status. Investment groups began gobbling up nursing homes over the past decade; CMS data shows the percentage of nursing home nationally that are operated as for-profits rose from 65.6% in 2004 to 67.4% in 2008.

As far back as 2001, a University of California, San Francisco study found "for-profit nursing homes are much more likely than their non-profit counterparts to be cited for deficient quality"; similar findings came from a federal study in 2008. (This 2007 New York Times story by Charles Duhigg describes how for-profit operators cut staffs after taking over non-profit nursing homes.)

Infection rates can be reduced all the way to zero, with proper procedures. But those procedures take time to execute. As Tina Rosenberg wrote on The New York Times' web site, hand washing "has to be done dozens or hundreds of times a day by busy health care workers who may be doing two or three things at once and have their hands full of supplies." It's harder to keep your hands clean when your workload is increased as the result of understaffing.

There are good reasons why California and other states have minimum staffing requirements for nursing homes -- and why there are penalties for failure to meet those requirements. The risk of spreading lethal infections is one of those reasons.

Continue reading "An Understaffed Nursing Home Will Be Hazardous to Your Health States Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck" »

The State of California has issued 15 citations, accusing an Oroville nursing home of illegally moving 14 residents out of the facility last year.
Olive Ridge Post Acute Care was ordered to pay $15,000 in fines because of the citations, which were issued in February of 2011 indicates California Elder Abuse Lawyer Steven Peck.

In early 2010, the nursing home staff told residents of a locked unit that they would have to move out, according to the California Department of Public Health. Olive Ridge administrators began finding other nursing homes around the north state that would take these residents.

A Department of Public Health document said the state was told the locked unit, which was for residents with Alzheimer's, dementia, psychosis and other ailments, was being phased out and would be converted to an unlocked unit.

Originally, there were 25 residents in the locked unit. By late February of 2010, 14 of them had been moved to other nursing homes. Another six were waiting to be transferred, and five were going to stay at Olive Ridge and be put in with the general population of residents.

A summary of the state's action against Olive Ridge was posted on the Internet by the watchdog group California Advocates for Nursing Home Reform.

It stated Olive Ridge was cited for breaking a number of laws, including those requiring that residents receive ample advance notice and that nursing homes file a relocation plan with the state.

According to federal law, the only valid reasons for moving a resident to another nursing home are that the move is necessary for the resident's health, the resident has gotten better and no longer needs the facility's care, the safety or health of the residents are endangered, the resident has failed to pay for staying in the facility, or the facility goes out of business.

In its summary, the reform group charged that by closing its locked unit, Olive Ridge appeared to be "following an increasingly popular model of nursing home care (of) moving out long-term residents who were perceived as difficult to manage to increase the available beds for short-term rehabilitation residents who pay more for their care."

Continue reading "California Nursing Home Illegally Evicts Elders says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck" »

The National Center on Elder Abuse defines seven different types of elder abuse: physical abuse; sexual abuse; emotional abuse; financial exploitation; neglect; abandonment; and selfneglect. These definitions are based on an analysis of existing State and Federal definitions of elder abuse, neglect and exploitation conducted by the Center in 1995 says San Francisco Nursing Home Abuse and Neglect Attorney Steven Peck.

Physical abuse: Use of physical force that may result in bodily injury, physical pain, or impairment.

Sexual Abuse: Non-consensual sexual contact of any kind with an elderly person.

Emotional abuse: Infliction of anguish, pain, or distress through verbal or non-verbal acts.

Financial/material exploitation: Illegal or improper use of an elder's funds, property, or assets.

Neglect: Refusal, or failure, to fulfill any part of a person's obligations or duties to an elderly person.

Abandonment: Desertion of an elderly person by an individual who has physical custody of the elder or by a person who has assumed responsibility for providing care to the elder.

Self-neglect: Behaviors of an elderly person that threaten the elder's health or safety.

Continue reading "A Description of Seven Different Types of Elder Abuse" »

The CMS (Medicare) cites about 15% of nursing homes each year for deficiencies in infection control, according to a study in the May issue of the American Journal of Infection Control. Infections contribute to more than 380,000 deaths annually among nursing home residents, and cost estimates associated with such infections can reach as high as $2 billion.

Researchers analyzed eight years of nursing home certification data, looking for infection control, or F-Tag 441, citations. While the per-year average citation rate was 15%, that number has actually trended upward, increasing from 12.87% in 2000 to 17.31% in 2007, according to the study. Adherence to infection-control certification standards varied from state to state, the authors found, and citations correlated strongly with low staffing levels and nursing homes' for-profit status.

"Our analysis may provide some clues as to the reason for the persistent infection control problems in nursing homes," indicates California Nursing Home Abuse and Neglect Attorney Steven Peck.

"Most significantly, the issue of staffing is very prominent in our findings; that is, for all three caregivers examined (i.e., nurse aides, LPNs and RNs) low staffing levels are associated with F-Tag 441 citations. With low staffing levels, these caregivers are likely hurried and may skimp on infection-control measures, such as hand hygiene." Peck says.

Continue reading "Nursing Homes Lack Infection Control says Los Angles Elder Abuse Attorney Steven Peck" »

Understaffing affects nursing home employees by causing high turnover, low morale, fatigue and physical injuries. Poorly paid nursing assistants provide the most direct care, and demands placed upon them are often impossible to meet says San Diego Nursing Home Abuse and Neglect Attorney Steven Peck,

Profit-driven multi million dollar corporations that own these institutions must be held accountable. The private-pay charge for a nursing home room is more than $5,000 a month. The charge for Medicaid residents is lower but still substantial. Yet, these facilities continue to be understaffed which causes our elder and dependant adults to be seriously neglected.

Continue reading "Understaffing is A Prime Reason For California Nursing Home Abuse and Neglect" »

Medicare patients at St. Joseph's Medical Center in Yonkers, N.Y., had the second-highest rate of severe bed sores in the country, according to an analysis of Medicare data between Oct. 1, 2008, and June 30, 2010, by the Sunlight Foundation Reporting Group on medical errors.

Medicare patients at St. Joseph's suffered 13 instances of severe bed sores during their stay requiring additional treatment, a rate of nearly 2.9 per 1,000 treated, according to the report. At nearby St. John's Riverside Hospital, the rate was 20 times lower: Only one severe bed sore was reported, even though the larger St. John's discharged 8,270 Medicare patients during the period, compared with St. Joseph's 4,541.

Bed sores--pressure ulcers--are one of the conditions that the federal government is increasingly unwilling to pay for. Earlier this month, Health and Human Services Secretary Kathleen Sebelius announced the Partnership for Patients, a new national effort that is meant to stop millions of preventable injuries and complications in patient care over the next three years. The federal agency said the initiative has the potential to save up to $35 billion in health care costs nationally, including up to $10 billion for Medicare.

The federal government is asking hospitals to focus on nine types of medical errors and complications where the potential for dramatic reductions in harm rates has already been documented. They include pressure ulcers, as well as preventing adverse drug reactions, childbirth complications and surgical site infections.

Continue reading "Elderly Patients At Long Term Care Facility Have An Extremely High Rate of Pressure Sores and Bed Sores says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck" »