California Elder Law Attorney Blog

Requiring more nurses to be on duty in nursing homes is key to improving care, according to a labor union and a watchdog group. Now, nursing homes are required to provide at least 3.2 hours of nurse staffing per patient per day. Some want the minimum raised to 3.5 hours.

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.

Continue reading "California Wants to Increase Nursing Home Staffing Ratio Per Patient Per Day" »

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

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

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

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

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

Reported cases of financial elder abuse, physical abuse and nursing home abuse and neglect inflicted upon elderly people are rising in California.

"Elderly people were beginning to speak up when they never used to, california elder law attorney Steven C. Peck says.

Figures for 2009 were not yet available but in 2008, in California, there were thousands of confirmed cases of elder abuse, which refers to abuse of people over 65. Most seem to concern abuse perpetrated by family members.

The most common form of elder abuse was financial.

Frequent cases included when families "helped themselves to their parents' money", demanded money for drugs and alcohol or moved in and lived off them Peck states.

Physical abuse also occurred and that sometimes was a result of unresolved family issues or alcohol and drugs.

Seeing an 80-year-old with bruises all over their face broke is terrible. However, the issue is not a new one. "It has always been there, it's just been hidden, says Peck.

"It's behind closed doors,"

Continue reading " Financial Elder Abuse, Physical Abuse, and Nursing Home Abuse and Neglect are Rising In California" »

A Ventura nursing home called Fillmore Convalescent Center, its owner, and one of its employees were hit with a $7.75 million verdict yesterday after a jury found them liable for elder abuse. It has to be one of the largest verdicts in California in a case involving nursing home abuse or neglect.

The facts are egregious. In 2006, the family of 71-year-old Maria Arellano, a stroke victim who was also non-verbal, began to notice suspicious bruising. They complained to the nursing home administration, but it failed to look into it. The family then placed a hidden camera in Ms. Arellano's room, which caught caregiver Monica Garcia slapping Arellano, pulling her hair, bending her fingers, and treating her violently. When the tape was revealed, Garcia was charged with criminal acts, and the family brought an elder abuse lawsuit against the nursing home.

The lawyer for Arellano, must have done an excellent job. He told the Ventura County Star that he offered to settle the case for $500,000, but was rebuffed. The nursing home, through its attorney Tom Beach, never offered a dime to resolve the case.

Ironically, Fillmore Convalescent received a five-star rating, the highest, from the Nursing Home Compare system, operated by the Centers for Medicare and Medicaid Services.

Continue reading "Ventura Nursing Home Found Liable for Elder Abuse in the Amount of $7.75 Million" »

Police are currently looking into a possible case of nursing home abuse that took place at Golden Moments Senior Care Center . The allegations include a nurse's aide threat to cut the throat of a 68-year-old man, slapping a woman, insulting other disabled and sick adults and taking the food away from starving residents of the said senior care center. In addition, there are also allegations that these horrible incidents took place for several months before these were reported to the administrator.

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

Continue reading "Nursing Home Abuse Still Very Very Prevalent" »

Nursing home abuse has been a topic of much discussion throughout the United States for several decades, but California is by far home to some of the most serious cases. The cities of San Diego and Los Angeles are particularly prone to nursing home abuse, although the problem is becoming more serious throughout the state every single year. If you suspect or are sure that your loved one has been abused or neglected in a nursing home in Los Angeles or San Diego, you should contact a personal injury lawyer immediately. Both neglect and abuse can result in the lasting physical and emotional wounds of your loved one, potentially requiring months or even years and hundreds of thousands of dollars to completely recover, if recovery is even possible.

There are different types of abuse one may be subject to endure while living in an ethically questionable nursing home. The first, and perhaps most common type of abuse evident in these types of environments, is neglect. Neglect is an indirect form of abuse in that a resident of a nursing home is perhaps being ignored or not receiving the care he or she wants and needs to be happy and comfortable. Neglect can cause both physical and emotional problems. There have been cases in which residents of nursing homes have been denied any reasonable amount of human contact for days and even weeks on end. Other forms of neglect could include not cleaning a resident properly when that resident is unable to adequately clean him or herself.

Direct abuse is also evident in nursing homes. Many nursing home employees have been convicted of hitting, kicking, punching, and attacking the residents for which they are hired to care and protect. Many residents are physically unable to inform their loved ones of this abuse. Others are threatened by the abusive staff, will result in more injuries, abuse and more pain. If you suspect at all that your loved one is the victim of nursing home abuse, do not hesitate to contact a personal injury lawyer right away.

Unfortunately, every year there is a substantial number of nursing home abuse victims who are unable to recover from the wounds they've received from either the direct abuse or intentional neglect of the staff supposedly dedicated to helping them. Many nursing home employees are taken to court and criminally convicted of these crimes each year. Although criminal charges may provide relief and justification to family members of the lost victim, criminal claims do not typically provide any sort of financial compensation to a victim's loved one. Financial compensation is often necessary to cover medical fees incurred while the victim remained alive or the costly funeral arrangements to lay your loved one to rest. In order to receive financial compensation to help cover these costs and others, personal injury lawyers help thousands of people each year in filing civil charges in addition to criminal charges. The civil charges for a personal injury claim will likely offer you and your relatives the financial support you'll require to carry on through the difficult mourning process.

Continue reading "Los Angeles County Facilities Seriously Prone to Nursing Home Abuse and Neglect" »

Currently pending in the U.S. House and Senate is the Fairness in Nursing Home Arbitration Act of 2009, which would amend the Federal Arbitration Act (FAA). This proposed law, if passed, will nullify mandatory arbitration clauses in admissions contracts for long-term care facilities. Supporters of the law are striving to protect this vulnerable population from exploitation by large corporations that want to keep elders out of court, where they can fight for their full legal and civil rights, and where damage awards might be much higher. Reasonable arbitration agreements could still be entered into later, but not as mandated parts of admission contracts.

Continue reading "Long Term Care Facilities Arbitration Clauses Will Be Nullified Should Fairness in Nursing Home Arbitration Act of 2009 Become Law" »

The family of a 96-year-old woman who developed a bedsore on her lower back was awarded $161,264 on October 20, 2009, in a lawsuit filed against her caregivers, but two local doctors also named in the suit were found not responsible for any wrongdoing.

Caregivers Edwin and Jane Ingan -- owners and operators of 10 care facilities in the county -- were found to be negligent for their role in taking Marian Eileen Kengel to Robert Schingler, who wasn't her primary care doctor.

Jurors also returned a verdict finding that Schingler and Dr. Grace Crittenden, Kengel's personal physician, weren't negligent in prescribing the medication Haldol to Kengel.

Schingler, who's based in Los Osos, was accused of other violations, including battery and elder abuse against Kengel. Jurors cleared him of those charges.

Schingler prescribed Haldol to Kengel, who developed a bedsore while a resident at the Sunrise V care facility in Los Osos. Kengel's family alleged the wound was caused by her immobility and the drug acted as a chemical restraint.

The Ingans said they made a mistake in taking Kengel to Schingler and plan to be careful to check their emergency contact information in their residents' charts in the future.

The plaintiff's lawyers accused the Ingans of intentionally keeping Kengel's family in the dark by not seeking their consent before taking her to Schingler.

Jury foreman Cynthia Jenkins of San Luis Obispo said it was difficult for the jury to come to its decision after two days of deliberations. She said she felt concern for each of the parties involved in the suit.

"We didn't think anyone was intentionally malicious," Jenkins said. "We did think there was some carelessness (regarding the Ingans). But it was a tough spot for everyone."

Continue reading "California Jury Awards $ 161,264.00 in Elder Abuse Bedsore Case" »

Governor Schwarzenegger has signed AB 1457 into law, which is a measure to confront the failing quality of care in nursing homes created by the lack of transparency in the ownership and management structure of these facilities.

AB 1457 will require each licensee of a skilled nursing facility to disclose with each abbreviated contract of admission the name of the owner and licensee for the facility and the name and contact information of a single entity that is fully accountable for all aspects of patient care and the operation of the facility. In addition, to ensure that existing residents of such facilities are notified of this information when there is a change of ownership, the bill requires written notification to all current residents and to their primary contacts listed on the admission agreement. The California Department of Public Health indicates that from January 1, 2007 through December 31, 2008, it received 135 Skilled Nursing Facilities change of ownership applications, and it approved 115.

"Nursing home abuse and neglect continues to be a serious problem in the United States. According to a report conducted by the Inspector General of the Department of Health and Human Services, 94 percent of all for-profit nursing homes were cited in 2007 for violations of federal health and safety standards," said Assemblyman Mike Davis (D-Los Angeles), author of AB 1457.

According to the California Health Care Foundation, California has more Long Term Care (LTC) providers than any other state: some 1,200 nursing homes, 14,000 residential care settings with varying levels of care, and a vast array of community-based services.

"The California Legislature and the Governor understand the special attention to the needs and problems of elderly persons. AB 1457 provides California an opportunity to address a serious problem detailed in dozens of investigations by reports in the media. Each resident should know who is in charge of delivering services in every facility. This measure will require appropriate notification which will help ensure quality care in nursing homes," Assemblyman Davis concluded.

Continue reading "Schwarzenegger Signs Quality of Care Bill for California Skilled Nursing Facilities" »

A San Diego County nursing home has received the most severe penalty under state law after an investigation concluded that inadequate care led to the death of a resident.
California Department of Public Health director Dr. Mark Horton said Wednesday that the Fallbrook Hospital District Skilled Nursing Facility received a "AA" citation and a $90,000 fine from the state.

Horton says the facility failed to implement a plan of care to prevent a resident's injury. A fall resulted in complications that led to the resident's death.

The facility can appeal the decision.

A phone message left after business hours with the facility was not immediately returned.

Continue reading "San Diego Nursing Home Receives Severe Deficiency Citation" »

Another person has been charged in a case of nursing home residents who were allegedly drugged against their will.

Kern Valley Hospital administrator Pamela Ott was charged Tuesday on eight felony counts of elder abuse for allowing staff to forcibly administer psychotropic medications to patients for their own convenience, rather than for their patients' therapeutic needs, according to a news release from the California Attorney General's office.

The druggings allegedly led to the deaths of three nursing home residents.

Three other people were charged in February for their alleged roles in the case. All of the defendants worked for Kern Valley Healthcare District's skilled nursing facility in Lake Isabella.

Former director of nursing Gwen Hughes, former pharmacist Debbi Hayes and staff physician Dr. Hoshang Pormir were arrested in February after a two-year investigation.

Medical complications, including lethargy and the inability to eat or drink properly, resulted from the forced medications, and three of the facility's residents may have died as a result, according to prosecutors. The patients who died were Mae Brinkley, 91; Joseph Shepter, 76; and Alexander Zaiko, 85.

Twenty-two patients were given high doses, and one surviving patient was greatly harmed, the investigation determined.

Hughes, starting in 2006, allegedly ordered staff to give high doses of psychotropic medications to Alzheimer's and other dementia patients to make them more tranquil and easier to control. Hughes allegedly ordered the medications be given to patients who argued with her, made noise or were otherwise disruptive.

In announcing the addition of charges against Ott, the attorney general's office said Ott hired and supervised Hughes and therefore is responsible, too.

"As hospital administrator, Pamela Ott was ultimately responsible for safeguarding the welfare of her patients," Attorney General Jerry Brown said in Tuesday's news release. "Instead, Ott abdicated her responsibility and allowed the staff of the Kern Valley Hospital to forcibly sedate patients who questioned their care."

Prosecutors said last month that former pharmacist Hayes was placed on probation and agreed to cooperate with the attorney general's office in its prosecution of the other defendants.

Contact Steven Peck's Premier Legal toll free at 866.999.9085 should you ever suspect the nursing home abuse and neglect of a loved one and visit us on line at www.premierlegal.org

Georgia Fitsos died in October 2007 of acute sepsis and other complications from what her family's lawyer calls "a bedsore the size of a turkey platter," a Stage 4 pressure wound that had eaten deeply into her flesh.

It was discovered almost by chance two months earlier, when Fitsos' son found her suffering unrelated shortness of breath. Paramedics rushed the 82-year-old woman to the hospital from a Folsom board-and-care home, the Broadstone Residential Facility.

Now Broadstone's owner and administrator, Adriana Catuna, and her husband, Viorel, are the focus of pending legal action on three fronts.

A felony elder abuse trial continues in mid-September, and the Fitsos family's civil suit, claiming negligence and wrongful death, goes to court a month later. The Department of Social Services' Community Care Licensing division began license revocation proceedings in late July.

Douglas Broomell, who represents Adriana Catuna in the civil litigation, declined to comment.

Lisa Franco, Adriana Catuna's criminal defense attorney, said: "I've had nothing but good reports from the other patients and families of patients who've stayed at the Broadstone. Mrs. Catuna is not guilty of the injuries that were caused.

"I hope things work out well for Mrs. Catuna," Franco added. "Her patients love her. She has a good case."

The Sacramento County Public Defenders Office, which represents Viorel Catuna in the criminal action, didn't return phone calls.

With a huge demographic wave of baby boomers sweeping into old age in the next two decades, the Broadstone litigation raises a number of issues.

Long-term care for the elderly isn't cheap: John and Peter Fitsos paid a monthly fee of $3,500, which rose to $4,500 in May 2007 after their mother suffered what the family said was a minor stroke.

State regulators monitor the industry, but patient advocates said enforcement can sometimes lag. Barring complaints, about one-third of California's 7,800 residential care facilities for the elderly are randomly inspected each year, said DSS Deputy Director Jeff Hiratsuka.

When families visit care homes, they see facilities that look clean and neat, and they assume this means elderly loved ones are well-tended, said Lesley Clement, an elder abuse attorney representing the Fitsos family in the civil matter.

"If you went into a day care center and found a child dehydrated with diaper rash penetrating to the bone and physically restrained because they're crying, you'd have the district attorney and attorney general's office lining up to take those cases," she said.

Too often, she said, care providers tell families their loved one would have died anyway - and families, who don't know where to turn for help, believe them.

Deputy Attorney General Steven Muni, who is prosecuting the criminal case, agrees.

"Working with law enforcement on elder abuse cases, we're where domestic violence was 20 years ago," he said. "We're still in the process of educating the public and the courts. The elderly are some of our most vulnerable people."

Georgia Fitsos emigrated from Greece to Sacramento in 1952 when she married a fellow native of the Peloponnese who was 30 years her senior. He died in the early 1960s, and she raised their two sons alone in east Sacramento.

She was diagnosed with Alzheimer's disease and dementia in 2006, and it quickly became clear to her sons that she couldn't continue living alone. That fall, she moved into a private room in the Broadstone, where, according to the facility's brochure, residents "can enjoy a lifestyle of Elegance!"

"I've been blaming myself for killing my mother for the past couple of years, because it was my decision for her to go to this facility," said retired attorney John Fitsos, 55, her older son.

He went by the Broadstone regularly to visit his mother, take her out to lunch and bring her to his house, he said.

In July 2007, he took pictures of her with a huge black eye. She told him someone hit her, he said, while Broadstone staff told him that she fell asleep sitting in her wheelchair at the dining table and hit her face on the table.

A month later, he found his mother suffering shortness of breath at the Broadstone and called 911 because, he said, the on-site attendant - who has since returned to her native Romania - didn't speak enough English to make the call.

Besides the bedsores, Mercy Hospital of Folsom personnel found that Georgia Fitsos, a diabetic, had high blood-sugar levels and extremely low blood pressure, according to medical reports. She died that October at the Bruceville Terrace skilled nursing center.

The initial investigation of Fitsos' complaints to Community Care Licensing resulted in Broadstone receiving a $600 fine in late 2007.

"I filed suit when I saw the system fall apart," said Fitsos, who wants to establish a nonprofit group to advocate for reform of the residential care industry.

"I'm not interested in blood money," he said. "I'm not interested in an adversarial situation. I'm interested in seeing legislation passed that really protects the public."

Please contact Steven Peck's Premier Legal to talk to an experienced elder abuse and neglect attorney toll free at 1-866-999-9085.

Tustin Care Center has been fined $50,000 by state health officials in the choking death of a nursing home resident.

The unidentified man died in March after choking on his lunch, according to an inspection report from the California Department of Public Health. The report says staff noticed the man had been growing weaker, but the facility still allowed him to eat regular meals on his own.

On the day of his death, the report says the man was eating soup with rice when he called for his wife, who was also a patient. The man struggled to breathe, and a nurse started the Heimlich maneuver but could not dislodge the food.

The man died later that day in a hospital. An autopsy found food completely blocking his trachea. The state report concludes that the nursing home failed to assess his ability to eat, which was a direct cause of his death.

In a call on Tuesday July 28, 2009, to the nursing home, staff said the administrator was out for the day and no one else could comment.

Immediately contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced nursing home abuse and neglect lawyer.

The California State Senate has approved Assembly Bill 392 (Feuer) with strong bipartisan support on a vote of 33-3. AB 392 would immediately provide $1.6 million for local Long-Term Care Ombudsman programs over the next year, ensuring protection from abuse and neglect for California´s vulnerable and elderly residents of nursing care and assisted living facilities.

"We need to take every step we can to protect seniors who may be at serious risk of abuse or exploitation," said Assembly member Mike Feuer (D-Los Angeles). "The funds provided to Ombudsman programs in AB 392 fill this important need during the next year. Isolated and vulnerable residents of nursing homes and assisted living facilities have nowhere else to turn, and their lives depend upon these programs being restored immediately."

Last year, Governor Schwarzenegger vetoed $3.8 million in funding for local Ombudsman programs, representing about half their funding. As a result of the cuts, the programs have been forced to lay off staff and drastically reduce services, compromising their abilities to investigate complaints and monitor facilities. Since these cuts have taken effect, residents have suffered the dire consequences of unchecked poor treatment.

In late June 2009, a Northern California facility owner and one care giver were arrested on suspicion of criminal abuse and neglect of a resident whose untreated pressure sores were so severe that they resulted in fatal sepsis. After the arrest, the two suspects posted bail and continued to collect payment to provide care for the six other facility residents. Unfortunately, without the funds provided by AB 392, the local Ombudsman cannot investigate how well the remaining patients are being cared for.

Local Ombudsman programs conduct frequent unannounced monitor visits to facilities, and they provide timely response to reports of suspected abuse and neglect. They investigate thousands of abuse cases each year. Without the scrutiny of the Ombudsman programs, the facilities are reviewed just once a year (or less) by government agency inspectors. Because no other program duplicates this critical advocacy service, the passage of AB 392 is especially important for residents´ quality of life and quality of care.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder abuse and neglect attorney.

A live-in caregiver arrested in connection with the heat-related death of a 90-year-old man and the hospitalization of his wife in eastern Contra Costa County has been released, authorities said today.

Laarni Dime, 57, was arrested on suspicion of elder abuse after she failed to turn on the air conditioner in the Discovery Bay home of George Brim.

Brim was found dead in his bedroom and his 85-year-old wife was suffering from heat-related injuries at about 11:15 p.m. on Saturday July 18, 2009, Lee said. The high in Discovery Bay that day topped 100 degrees.

Dime was released late Monday while the investigation continues.

Should you ever suspect the elder abuse and neglect of a loved one, immediately contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced nursing home abuse and neglect attorney.