The nursing home industry quickly signaled displeasure with the bill, saying the proposal "goes way beyond" issues addressed by Gov. Pat Quinn's nursing home safety task force. But one of the bill's sponsors, Sen. Jacqueline Collins, D-Chicago, said her coalition is ready for a fight.

"We are here to say quite boldly and courageously that we're willing to take on the nursing home industry," Collins said at a news conference in Springfield. "For too long they've had the influence and power in this state and I want to say that we can mount a strong coalition to stand together to fight for policy changes that truly address the disparities in care and the lack of care."

The proposal targets a pattern of violence in Illinois nursing homes stemming from the state's long reliance on the facilities to house younger adults with serious mental illness. Assaults, rapes and murders reported in a series of news articles sparked the formation of the governor's task force.

The nursing home industry has been taking part in talks in Springfield with members of the task force working toward legislation, said Terry Sullivan of the Health Care Council of Illinois, the state's largest nursing home trade group.

So too have advocates who broke out of the talks Tuesday to announce their proposal and press the points on higher staffing and fines.

Sen. Heather Steans, D-Chicago, is sponsoring the legislation with Collins. It's backed by groups such as AARP, unions representing health care workers, the Supportive Housing Providers Association and Illinois Citizens for Better Care.

"Thousands of nursing home residents across this state are victims of abuse, of assault and inadequate care," said Nancy Funk, an AARP volunteer from Decatur, at the press conference. "It kind of looks like it's becoming the norm in this state rather than the exception."

The proposal calls for a database of nursing home assaults that would be kept by the Illinois Department of Public Health and a new tax on nursing homes to increase funding for the state long-term care ombudsman program, which sends trained advocates into nursing homes to help residents.

Sullivan of the nursing home group said raising taxes would take money away from what's available to care for patients. He said increased staffing for every nursing home isn't reasonable.

The bill "goes way beyond issues raised in the governor's task force," Sullivan said. "For years and years, the state has been cutting back on the ombudsman program and public health surveyors and now suddenly they say, 'We need more people. Let's make nursing homes pay for that.'"

Meanwhile in California, Villa Valencia confronted another nursing home abuse lawsuit when Theresa Sperry, a 91-year old woman died due to Alzheimer's and painful pressure ulcers on her feet. The family of Sperry cited negligence and excessive profit-orientation of the said nursing home as main reasons why Theresa Sperry died.

These two cases are two examples of nursing home abuse which is becoming prevalent in many nursing homes across the United States. Nursing home abuse has become a pressing issue nationwide as reports show that thirty percent of the facilities in the United States are cited for cases of abuse. What is more alarming is that nursing home abuse statistics shows that these instances of nursing home abuses are never reported to the authorities.

If your loved one is elderly and is currently confined to a nursing home, it is imperative that you should look into his or her welfare. One way of ensuring the welfare of elders is knowing some of the caveats of nursing home abuse. Here are some of the most commonly observed signs of physical abuse.

Assault
Battery
Rape
Sexual Assault
Unreasonable physical restraint
Elder reports incidences of being slapped, ridiculed or mistreated
Deprivation of food or water
Giving improper medication
Unexplained injuries
Caretaker cannot sufficiently explain condition of the elder
Open wounds, cuts, bruises or welts
Slapping, pushing, shaking, beating

Other indication of nursing home abuse is negligence of caretakers or nursing home personnel. In addition, some signs of neglect on the part of caretakers include disregarding the needs of elders, neglecting medical problems, failing to help in personal hygiene, failing to maintain clean and safe conditions and failing to protect from health and safety hazards.

Sometimes, physical abuse and negligence are not the only abusive things that take place in our nursing homes. Verbal and emotional abuse is also common. Let us take a look at some signs that might tell you that your loved one in nursing home is experiencing verbal and emotional abuse.

Agitated or upset elder
Strange behavior like non-communicative or withdrawn
Frightened
Wanting isolation from the people

Nursing home abuse can take many forms, including physical abuse, sexual abuse, financial abuse, and emotional abuse. When nursing homes are understaffed or caretakers fail to receive proper training and supervision on the job, seniors may not get the level of care that they need and deserve. The effects of nursing home abuse can range in severity from discomfort to serious injury, and even wrongful death. Bed sores, broken bones from falls, dehydration, and malnutrition are just a few of the life threatening conditions that can result from neglect and abuse in nursing homes states California Nursing Home Abuse and neglect Attorney Steven C. peck.

It is important to note that nursing home abuse and neglect can be difficult to detect and may be missed if a concerned family member is not watching out for their elder relative. In some situations, a nursing home resident may be afraid to seek help because of threats made by the abusive staff member. In other cases, the victim may be physically or mentally unable to communicate that he or she is suffering from nursing home abuse.

It seems that a 76-year-old patient--whose identity is being withheld--had to wait for about 12 hours before she received treatment for a broken shoulder and two broken legs, said the Daytona Beach News Journal, citing a DeLand police report. The female patient fell out of her bed at 5:00 am Friday, when her bedding was being changed, said DeLand police Deputy Chief Randel Henderson, wrote the Daytona Beach News Journal.

The woman was put back in her bed after the accident, but it took until the next shift change at 4:42 pm, for emergency workers to be brought on the scene and help with her injuries, said the Daytona Beach News Journal, which added that the patient was ultimately admitted to the Halifax Health Medical Center in Daytona Beach. The nursing home has not responded to media requests for comment.

The Agency for Health Care Administration--responsible for 31 nursing homes in two Florida counties--is reviewing the matter, according to the Daytona Beach News Journal. Ridgecrest Nursing and Rehabilitation Center's state license is current and its last inspection took place in October at which time, nine deficiencies were noted, including accident hazards and food storage issues, reported the Daytona Beach News Journal.

We've long been following the issue of nursing home abuse, recently writing about a Brooklyn nursing home ordered to pay about $19 million in damages to a family whose loved one allegedly died as a result of abject neglect. We also wrote that ABC World News reported that a California nursing home used chemical restraints--drugs--to silence residents. In some cases, this practice was fatal.

On a number of occasions we have written about the dangerous issue surrounding the dosing of medications to the elderly, specifically antidepressants, antipsychotics, and sedatives. Sometimes these medications are given for seemingly pointless reasons and, on occasion, these medications appear to be linked to falls and other accidents in the elderly. Science Daily just reported that such accidents among the elderly are "significantly" linked with these drugs--sedatives to help patients sleep and drugs used to treat mood disorders--citing a study conducted by an expert in "pharmaceutical outcomes research" out of the University of British Columbia.

We also recently wrote that the Chicago Tribune broke with an exposé on how some powerful psychotropic drugs are given to nursing home residents in Illinois without consent and valid psychiatric diagnoses. Some have suffered from a variety of adverse responses that include, said the Tribune, "tremors, dangerous lethargy, and a higher risk of harmful falls or even death."

When seniors are abused--emotionally, physically, financially, sexually, or through neglect--the risk of death increases by more than double, according a recent study, said Medicine Net recently. Sadly, according to Food and Drug Administration (FDA) data, anti-psychotics that are inappropriately prescribed, kill 15,000 nursing home patients annually, said ABC.

"It's usually someone who is taking advantage of the trust and also taking advantage of the vulnerabilities," says California Elder Law Attorney Steven C. Peck "Preying on someone's financial situation."

While statistics aren't always available at the local level, that doesn't mean it's not an issue.

"The one thing you don't want to do is put your head in the sand and pretend this thing doesn't exist, because this is happening all across the country," Peck Indicates.

Many older adults are afraid to report abuse, They might be reliant on the perpetrator for their independence, or they might just not know who to tell.

"We definitely need to stop this," reflects Peck "We're hoping we can connect with seniors to tell them there are resources here for them to reach out and stop this type of exploitation.

Even when elder abuse cases are reported, they're often difficult to investigate. For example, if children are charged with taking care of their parent, it's common to share a bank account so the children can eventually make funeral arrangements. Once that happens, the temptation grows to start taking money out for personal use, maybe even thinking of it as an early inheritance, indicates California Financial Elder Abuse Lawyer Steven C. Peck.

"It is difficult because you have to sort through those trust issues and get to the facts," Peck says. "You have to prove that these people are being taken advantage of."

The investigations can be time consuming, even when advocates help the victim. "Like most of us, the elderly don't keep the best records, so pouring through records is really very difficult to do,"

Surprisingly, a large number of nursing home residents are not being given the care and attention they deserve. Whenever the nursing home owner or person responsible for taking care of his nursing home resident fails to fulfill his obligation, nursing home neglect has just occurred. One might say a person has been neglected when the staff of a nursing home is not able to provide the resident with everyday necessities such as water, food, or professional care. Needless to say, the resident can be afflicted with health problems or injuries as a result of nursing home negligence. Various conditions might indicate a nursing home resident has been subjected to nursing home neglect or nursing home abuse. Some signs include cuts, bruising, dehydration, bed sores, symptoms of malnutrition, untreated wounds, behavioral swings, and general unsanitary environments.

Whenever you suspect a loved one has suffered from nursing home neglect or any form of nursing home abuse, it is advisable to call your local police right away and file a formal complaint. After you file a nursing home negligence report with the police, the next best thing to do is consult with an experienced nursing home abuse attorney that can handle that type of case in your State. A top nursing home abuse lawyer will be able to advise you of your legal recourse and represent your loved one if nursing home negligence or nursing home abuse is apparent. Should your nursing home lawyer recommend a lawsuit, the nursing home owner and its staff may be convicted of nursing home neglect and be held liable for restitution.

A clear cut example recently made headlines in a number of financial trade publications. Two stockbrokers named Thomas B. Cooper and Peter L. Boorn at Beverly Hills-based StockCross Financial Services Inc. allegedly bilked a 95-year-old investor named David Wolfson of nearly all his assets and put his house at risk after recommending unsuitable and risky investments. The brokers dropped Mr. Wolfson as a client once they drained him of his cash. An arbitration panel awarded Mr. Wolfson triple damages in the amount of $1.6 million, an unprecedented amount, underscoring the severity of the abuse.

Exploiting the elderly is actually quite common on Wall Street. There isn't a lot of money to be made managing the accounts of risk-averse investors who are looking to clip coupons and live off the interest income from their investments. Some Wall Street firms just can't help themselves and see the elderly as ripe for the picking.

Another recent example was the case of Sergio M. Del Toro. Mr. Del Toro is now banned from the securities industry for defrauding a 90-year-old Minnesota man who lived in a nursing home of $511,000. Mr. Del Toro recommended that the elderly man put his entire net worth into the company stock of a firm called 3rd Dimension, for which there was no market or publicly quotable pricing. Mr. Del Toro's alleged motiviation was a classic one: he received a 15 percent commission, or about $76,650.

Elder abuse can also take the form of sales of securities that on the surface seem reasonable but in fact are inappropriate. Although FINRA specifically warned brokerages in 2007 against taking advantage of elderly investors, it didn't stop Wall Street in 2008 from targeting the elderly with investments that preyed on their need for liquidity. The most common of these investments were the preferred shares of major financial institutions that offered attractive dividends.

This in a excerpt from a CNA "One of the many duties of a CNA, or certified nurse assistant, is to help the residents of the nursing home with their morning routine. While assisting a certain resident, I noticed the sliding doors of her closet were broke and one of them wouldn't open without forceful tugging. After getting her clothes together, I opened a drawer for some socks and a few roaches crawled out from the haphazardly bundled clothing. I later discovered most of the rooms in this particular facility were in the same appalling condition.
Mysterious injuries to some of the mentally handicapped residents also created rumors of abuse. Yet, no one seemed to know anything about it. Through the Medicare and Medicaid programs, the federal government is suppose to conduct on-site inspections of nursing homes participating in Medicare and Medicaid and to recommend sanctions against those homes that are violating health and safety rules. Yet, this particular facility, on several occasions, somehow received a Five Star rating after "inspections".
I assumed I made a bad employment choice and the next nursing center would be better. I was wrong. Within three months of employment at a different facility, a couple of senior residents confided that a certain nursing assistant was handling them roughly. Being the young newbie to the status quo, I hesitated to act. I was aware the elderly could be quite fragile, so perhaps the manhandling they described was a misunderstanding. Then I witnessed this same assistant "person" placing a soiled diaper onto the face of a resident several times in a teasing manner. I had seen enough, I brought this to the Director of Nursing (D.O.N).
I was not aware at the time however, that both the nurse of that shift and the D.O.N were both friends of the abusive assistant. Therefore, when a meeting was finally convened on the matter about a month later, you can probably imagine what the outcome was. My heated defense of the residents fell on deaf, dumb and blind, ears. The so-called nurse defended the abuser and the D.O.N merely pointed a finger at this assistant and said, "You were wrong." and absolutely nothing else followed, not even a written reprimand. However, I became known as the "trouble-maker" shortly after the meeting.
Fortunately, there was some poetic justice; the abusive assistant was later fired for getting into a "fist-fight" in an elevator with another assistant. This was a "Holy" facility in the suburbs of Illinois.
A large man with documented psychological problems abused other residents at the last facility in which I was employed. Although there were several staff complaints and he choked a female caregiver at one point, his transfer to a more appropriate facility was continually delayed to maintain the profits of his stay. It therefore seemed unconscionable to hear the, oddly high-strung, administrator of this same facility was rumored to be embezzling holiday funds that were meant for the caregivers.
When I learned a new policy required completely untrained caregivers to pass medication to the residents, I began to update my resume, and when I learned that there wouldn't be a nurse at all for the night shift, I turned in my two weeks notice. It was an obvious attempt to save money by limiting or eliminating professional care. These facilities never mention to visiting family members that when the patient or resident census is low, the nursing assistance is often cut to save money. This practice can lead to neglect, which tends to create new issues, such as bedsores for the bedridden residents.
There was a certain focus prevalent among the many facilities in which both my wife and I were employed and apparently, nothing has changed. They all claimed the well-being of the resident is the primary concern; some even placed impressively framed statements or plaques on the walls with their creeds of care. There was no fine print however, that stated the true primary concern above all else was Money. Making money and saving money. A single resident brings in five to eight thousand dollars a month and in "special care units" such as an Alzheimer's unit, it can be $10,000 a month. Thus, everything, and I do mean EVERYTHING else, is of lesser importance. What makes this statement all the more outrageous is that it may actually sound naïve to some, in today's corporate controlled world. "Of course it's about money, what else could it be about?"
It should be mentioned the examples given above are extreme and may not necessarily occur in all nursing centers. However, the Centers for Medicare and Medicaid Services (CMS) on February 5, 2008 named 4,037 nursing homes whose pressure sore and/or physical restraint rates it says have targeted them for "improvement". Thus, anyone who is considering a nursing home or assisted living facility stay, for either a loved one or themselves, should consider and understand the reality of these facilities and the possible measures that can be taken to promote better care."
So, what can you do if you believe extended assisted living or nursing care is needed for you or a loved one? Here are some suggestions and options you might want to consider says California Nursing Home and Abuse Attorney Steven C. Peck.
- If distance is not a major concern, you may be able to locate a decent facility via the Senior Housing Net.com site. After choosing a place, if you have the means, research the facility. Find out what you can about it before you visit it. Perhaps you can check for recent complaints, or any history of lawsuits, with the Better Business Bureau online. If this is not an option, arrange a visit and ask the residents about the care, their rooms, the food, etc.
- Notice if you can detect urine when you enter the facility. If there is no one in the immediate area and the odor is very noticeable, we suggest that you turn around and leave. It is a telltale sign of poor sanitation and or possible neglect of bedridden patients.
Most assisted living centers are modeled impressively to give a beautiful "Home-like" appearance and most new residents agree it is much better than the sterile-looking hospital appearance of many nursing homes. However, do keep in mind; it is not necessarily an assurance of superior care. In other words, appearances can be deceiving.
- Ask about the training background of the CNAs (certified nursing assistants) or caregivers, they will be assisting you or handling your loved one the majority of the time. Many assisted living centers do not require their caregivers to be certified assistants, choosing to hire untrained or inexperienced caregivers who are then asked to attend an in-service or two.
- How many caregivers or CNAs are assigned to each unit? How many nurses are there to a unit? Is the ratio to patients or residents adequate for dependable care?
If you must stay at a facility of questionable quality, try to arrange any of the following:
- If possible, have a lawyer present when filling out the admission forms. Some may say it is an unnecessary waste of money, however, nursing facilities abhor any possible legal action against them and a lawyer intimidates much like a wooden cross does when held up to vampires.
- Arrange periodic unannounced visits from family or friends. This serves more than one purpose. First, it provides witnesses to any neglect or problems. Second, it helps keep the staff on their toes regarding your care. Should any incidence of abuse occur, a quick internet search provides a long list of nursing home abuse lawyers.
- If you are a visiting family member and your loved one is in bed most of the time, check for any bedsores on the heels, hips, buttocks, back or elbows. It is your Right to thoroughly question any injuries and be certain they have been properly documented and the doctor has been informed.
- If it is within your budget, you may choose to hire a reliable private sitter to provide one-on-one assistance or care within the facility. Many families prefer this option as it provides not only constant personal attention but companionship as well. Facility staff appreciates it for the relief it can bring during a high census. As an experienced private sitter, I can attest that it is much more preferable to care for one patient than to juggle ten or twelve.
- Another option that may save you money is to hire a private home sitter. Many patients obviously prefer this because it allows them to stay in their home with a caregiver to assist them. A nurse will often be required to make periodic visits as well for any medication that must be administered. There are many agencies to assist you with this.
Although there are many negative stories about nursing facility care, it does not mean you, or a family member, will have the same negative experiences. Believe it or not, there are plenty of satisfied residents, or patients, who do not regret their move into an assisted living or nursing home and who have made new friends.
So, now that you have been given some worst-case scenarios, says California Elder Law Attorney Steven C. Peck who may be reached toll free at 1.866.999.9085 and on-line at www.premierlegal.org. Here's hoping you are prepared for the worst but experience the best.

Legislation that became law in 2008 mandated that an 18-member "workgroup" be formed to recommend how to improve care in nursing homes indicates California Elder Law Attorney Steven C. Peck.

The workgroup included members representing nursing home owners, the SEIU, the watchdog group California Advocates for Nursing Home Reform (CANHR), senior citizens groups and others.

The group was concerned with Assembly Bill 1629, which changed how nursing homes are paid and provided them with higher payments. The workgroup held a number of meetings. Its efforts were overseen by the state Department of Health Care Services, which was supposed to issue a report to the Legislature last March.

The report is still being finalized, said Lisa Gray, a spokeswoman for the department. She said she couldn't give a date when it's expected to be released.

Each member of the workgroup produced a list of recommendations for improving care at nursing homes. SEIU and CANHR both recommended raising the minimum nurse staffing level from 3.2 to 3.5 hours.

The union wrote that plans should be made, also, for how to reach the staffing level of 4.1 hours that some experts have recommended.

CANHR recommended that nursing home rate increases should depend on homes' meeting the 3.2-hour minimum. "We don't think they should be granting any rate increases to homes that don't meet 3.2," said Mike Connors, a CANHR advocate who served on the workgroup.

Last year, a bill was introduced in the Legislature that would have required nurse staffing levels to be at least 3.5 hours per day per patient, in place of the current 3.2 hours requirement.

Assemblyman Warren Furutani, D-Gardena, introduced the legislation, but he later withdrew it at the request of its sponsor, the SEIU, said Leilani Yee, Furutani's legislative director. Mary Gutierrez, a spokeswoman for the union, said the SEIU felt it couldn't do a good job of promoting the bill when it was so focused on the state budget. The measure might be introduced again next year, she said.

On another matter, both CANHR and the SEIU objected to nursing homes' being able to use money it received through Medi-Cal to buy liability insurance.

CANHR said the practice should be stopped altogether, while the SEIU called for controlling how much could be spent for that purpose. Owners of nursing homes who participated in the workgroup also made recommendations.

They called for making AB1629 a permanent law.

They also recommended measuring how satisfied residents, families and staff are and including that information in nursing-home ratings.

2) Has there been "financial abuse?"
Everyone has the right and capacity to dispose of their property as foolishly as they choose. If they have been subjected to unusual pressure, duress, coercion, trickery, artifice or device to part with their property to the benefit of some other person, there may be elements of financial abuse.

3) Is the object of the elder's bounty a fiduciary or enjoy a confidential relationship?
When a person has a fiduciary or confidential relationship with the elder and has received property or value from the elder, there may be a presumption of fraud without proving actual fraud or any lack of competency of the elder.

4) Does the elder suffer from any medical or mental condition?
If at the relevant time the elder is suffering from mental or medical conditions which materially affect his or her ability to resist the importuning of others, resulting in the impoverishment of the elder and/or otherwise benefiting the recipient of the elder's largesse, grounds may be established for a case of elder abuse.

5) Does the elder require appointment of a conservator?
If the elder does not seem able to take action by himself or herself to stop the financial abuse and seek recovery directly against the recipient, then some person must apply to the probate court to be appointed conservator to seek recovery.

6) If the elder has passed away, appointment of an estate representative may be required.
Frequently elder abuse is not discovered until after the elder has died, in which event someone (usually a natural heir) must seek appointment as estate representative and sue the recipient for recovery of any property obtained as a result of elder abuse during the elder's lifetime.

7) Remedies include damages, attorney fees, injunctive relief.
The good news is that a successful case to recover property obtained by elder abuse may include damages (including punitive), attorney fees, and injunctive orders requiring the recipient to disgorge the ill-gained assets and their proceeds.

Is there anything one can do if this has happened to your elder? Yes, there may be something you can do. First, if the elder has "cognitive impairment" or has been diagnosed with dementia, it is important to get a letter from the elder's physician verifying that he or she is not competent to handle his or her finances any longer. Without medical or psychological evaluation of the elder and evidence from one of these professionals, it is almost impossible to protect the elder from financial abuse.

One way around the problem is to seek the advice of an elder law attorney, who may be able to convince the court to order an evaluation, even if the "agent" objects to having the elder tested for competency by a doctor.

If an agent on a durable power of attorney has taken control of the elder's finances and is not using the elder's money for the elder's benefit, it may be time to get the authorities involved. Taking an elder's money and using it for any purpose other than to care for and protect the elder's health, safety and quality of life may be financial abuse. If so, it must be reported to the police, adult protective services in your area, or to a doctor, who will report the problem to the proper law enforcement entity. The letter reporting the evaluation of the elder's mental competency is a crucial part of reporting alleged elder abuse. Without it, law enforcement may not be able to tell who is being truthful and who is not.