California Elder Law Attorney Blog

A federal agency has released health quality data that show troubling statistics about nursing home care in California. The data show almost one in 10 long-term nursing home patients was physically restrained in 2008.

The state snapshot also said that some 27 percent of short-stay nursing home residents had bed sores that same year. In these areas, California ranked last among the states.

Bill Freeman of the Agency for Healthcare Research and Quality said he hopes the numbers are useful to lawmakers. The agency found the state was 'average' in overall quality of care.

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Continue reading "Nursing Home Care Is Very Troublesome In the State of California" »

Clinical Conditions that may evidence the risk of Dehydration and / or electrolyte chemical inbalance are as follows indicates Los Angeles Nursing Home Abuse and Negelct Attorney Steven Peck:

Dementia or cognitive impairment
Fever (including low-grade fever)
Diarrhea
Vomiting
Dependence on staff for eating and drinking
Use of medications that can cause dehydration (e.g., diuretics, phenytoin, lithium, laxatives)
Draining wounds or pressure ulcers
Excessive sweating
Rapid breathing
Gastrointestinal bleeding
Previous episodes of dehydration
Difficult or painful swallowing
Depression
Small amount of dark or concentrated urine
Excessive urination
Nothing-by-mouth or fluid-restriction orders
Chronic comorbidities (e.g. stroke, diabetes, congestive heart failure)
Infection
Dizziness
Environmental Factors

Tube feeding
Use of specialty beds
Lack of social or family support
Inadequate staffing
Language barriers
Isolation
Restraints
Facility-specific factors that may expose patients to excessive heat (e.g. malfunctioning air conditioners)

Risk Reduction. A facility-wide hydration program can contribute significantly to decreasing the risk of dehydration. The certified nursing assistant (CNA) can be a major resource for this program. Regular rounds for fluid distribution, one-on-one help with consuming fluids, records of fluid intake and output if indicated, and reporting of warning signs that caregivers have been trained to recognize all play a part in a facility-wide effort to reduce the risk of hydration problems.

Hydration should be considered part of everyone's job. Every staff member should be trained to help manage hydration and to offer fluids as appropriate, and all staff should be involved in managing hydration. All caregiving staff should pay attention to such issues as why a patient may not be consuming fluids that are offered and ensuring that a patient's liquid preferences are identified. Questions about these issues should be asked of patients or of their family members or other advocates when patients are unable to respond.

Continue reading "Conditions and Factors That May Increase Risk for Dehydration or Fluid/Electrolyte Imbalance" »

Signs of VRSA

VRSA is vancomycin-resistant Staphylococcus aureus. VRSA can result from treatment of MRSA with vancomycin and teicoplanin. The patient may become resistant to the original infection, as well as the drug being used to stop the infection from spreading. This particular bacterium is rarer than MRSA, but it does occur with increasing regularity. The bacteria will thicken the cell walls depleting the amount of vancomycin that enters the blood stream and kills the bacteria. Patients with this infection must be isolated to avoid spreading it throughout the rest of the SNF. They may also have to be placed on a pump to clean out their system of the vancomycin before trying another drug. The bacterium has to be isolated in the body to help eradicate it.

Looking for Risk Factors

VRSA and MRSA are just two inflectional bacterium found in SNFs that you should look for before placing a loved one. To keep residents at SNFs free of this inflectional bacterium the staff must provide proper housekeeping, hygiene, and keep to federal and state regulations regarding care facilities.

Continue reading "VRSA Can Be Deadly In Nursing Homes And Can lead To Death Says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck" »

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" »

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" »

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" »

How are you able to know if your loved one is being neglected in a nursing home?

When you go to visit, everything appears fine, but your loved one is unable to express his/her ache to you in words. Each time a nurses aide is available directly into attend to your loved one, you noticed a big sore on the aspect of their leg. When you query it, the nurses aide statements that it is noting but a simple sore. What you come about to be actually looking at are evidence of neglect says California Nursing Home Abuse and Neglect Attorney Steven C. Peck.

A decubitus ulcer is commonly acknowledged like a bed sore. A decubitus ulcer are often a simple red or pink mark on the skin or it are often as terrible like a very deep sore that reaches into the bone or inner organ. they are caused by prolonged pressure on a unique aspect of the body system and therefore are seen on patients who are bedridden (Thus the name, bed sore).

Most nursing services possess a policy to change bedridden patients the moment in time almost every two hrs like a way to halt decubitus ulcers from forming. If your loved one has these decubitus ulcers, also known as bed sores then they are not being turned in the bed as regularly as necessary and this generally is Neglect in a nursing home.

These Bed Sores, Pressure Sores and decubitus ulcers can cause further complications, which include passing away if not treated. Therefore, if you actually have seen Bed Sores, Pressure Sores and decubitus ulcers on your loved one, ensure that you immediately consult using the doctors and nurses in the facility. when their responsibility falls short and they fail react or offer you a reasonable answer to why there are Bed Sores, Pressure Sores and decubitus ulcers on your loved one, then ensure that you consider filing a a complaint for nursing house neglect says Peck law Group Elder Abuse Attorney Steven C. Peck.

The Bed Sore, Pressure Sore and decubitus ulcer could be very painful. So, your loved one might probably be in serious jeopardy and unable to express their pain. They might probably be crying for help, but no one is listening. this is neglect. No one should have to endure the ache of Bed Sore, Pressure Sore and decubitus ulcer. Turning or repositioning your loved one almost every two hrs will prevent these ulcers from forming.
It is true that decubitus ulcers are considered preventable plus the development of decubitus ulcers is evidence of some kind of neglect. Many paralyzed or terminal individuals with very poor nourishment are often zero cost of those ulcers. This are often achieved by good patient care.

Continue reading "How Do You Know When Your Loved One Is Being Neglected and / or Abused In A Nursing Home?" »

A decubitus ulcer is a pressure sore or what is commonly called a "bed sore". It can range from a very mild pink coloration of the skin, which disappears in a few hours after pressure is relieved on the area, to a very deep wound extending to and sometimes through a bone into internal organs. These ulcers, as well as other wound types, are classified in stages according to the severity of the wound.

All decubitus ulcers have a course of injury similar to a burn wound. This can be a mild redness of the skin and/or blistering, such as a first-degree burn, to a deep open wound with blackened tissue, as in a third degree burn. This blackened tissue is called eschar.

Mechanism of Formation:
The usual mechanism of forming a decubitus ulcer is from pressure. However it can also occur from friction by rubbing against something such as a bed sheet, cast, brace, etc., or from prolonged exposure to cold. Any area of tissue that lies just over a bone is much more likely to develop a decubitus ulcer. These areas include the spine, coccyx or tailbone, hips, heels, and elbows, to name a few. The weight of the person's body presses on the bone, the bone presses on the tissue and skin that cover it, and the tissue is trapped between the bone structure and bed or wheelchair surface. The tissue begins to decay from lack of blood circulation. This is the basic formation of decubitus ulcer development.

Nursing Care, Prevention and Treatment of Decubitus Ulcers:
The common areas of decubitus ulcer formation and prevention is a basic nursing principle covered in nursing school curriculum (LVN/LPN or RN) and most nursing assistant programs as well. Prevention consists of changing position every 2 hours or more frequently if needed. This 2-hour time frame is a generally accepted maximum interval that the tissue can tolerate pressure without damage. Prevention also consists of protection and padding to prevent tissue abrasion, and maintaining hydration, nutrition and hygiene.
Protect your loved one from nursing home neglect or abuse talk to California Nursing Home Abuse and Neglect Attorney Steven C. Peck toll free at 1.866.999.9085.

The treatment for a decubitus ulcer involves keeping the area clean and removing necrotic (dead) tissue, which can form a breeding ground for infection. There are many procedures and products available for this purpose. The use of antibiotics, when appropriate is also part of the treatment. Some deep wounds even require surgical removal or debridement of necrotic tissue. In some situations amputation may be necessary.

The second portion of the treatment involves removing all pressure from the involved area(s) to prevent further damage of tissue and to promote healing. Frequent turning is mandatory to alleviate pressure on the wound and to promote healing. Along with cleaning, removal of dead tissue, and alleviating pressure, the individual must have increased nutrition to allow for proper healing of the wounds. Without all of these elements being in place, the wounds will not heal and, in fact, will quickly worsen.

Prevention:
The basic treatment of decubitus ulcers is prevention. Prevention cannot be stressed too strongly. To this end, there are any number of devices designed to protect and prevent the formation of decubitus ulcers. The decision of which device to use is based on the location and severity of the wound. These devices may be a Medicare/Medicaid/Insurance-covered item when medically necessary. Most insurance's will cover any needed device, material, or equipment necessary to prevent and treat decubitus ulcers. Prevention is the most humane and cost effective approach to care.

Standards of Care:
It remains true that decubitus ulcers are generally considered preventable and the development of decubitus ulcers is evidence of some form of neglect [nutrition, hydration, positioning, infection control, etc]. Many paralyzed or terminal individuals with very poor nutrition can remain free of decubitus ulcers. This is accomplished by good patient care often being provided by family members and non-licensed hired caregivers. Professional medical personnel generally provide only a minimum amount of medical assistance. Prevention is achieved by diligent care.

Decubitus Ulcer Formation and Treatment in Long-Term Care Facilities
In long-term care facilities the rate of decubitus ulcer development is higher for a variety of reasons. Due to staffing shortages, medical funding cuts and an array of issues, most long-term care facilities are chronically understaffed. This results in patients not being turned, cleaned and fed as often as the ideal standard of nursing would dictate.

It is known that almost all decubitus ulcers are preventable. However the reality of long-term care concludes that if a patient does not have massive weight loss, chronic infections, or wounds that do not heal in two weeks then that individual is receiving a reasonable standard of care. It is not uncommon for small wounds to develop, be treated and heal quickly. This is considered adequate care.

Massive weight loss, massive deep wounds over Stage II and chronic infections continue to be an unacceptable standard of care. Massive wounds are generally a strong indication of negligence in more than one area [hygiene, nutrition, infection control, positioning, etc.].

Another emerging factor in long-term care is patient directed care. Alert and generally oriented individuals determine their own care. These persons, though elderly and frail, are not declared incompetent. Patient's rights, as it is currently practiced, allows for patient refusal of medications, food, fluids and treatments such as turning. This often results in a lesser quality of care being provided due to patient noncompliance. When this occurs, the ideal situation is to involve the patient, family, staff and physician in a plan of care that will be acceptable and beneficial. Patient refusal of nutrition and positioning may lead to the development of decubitus ulcers as well.

In summary: In almost all situations, the development of massive decubitus ulcers is evidence of some form of neglect. Generally the neglect is in more than one area, i.e., hygiene and nutrition. It would be a very rare exception for this to not be true.

Decubitus ulcers need to be viewed as a preventable injury, not an excusable one.

Stages of Wounds:
Wounds are often categorized according to severity by the use of stages. The staging system applies to burn wounds, Decubitus ulcers, and several other types of wounds.

Stage I
This stage is characterized by a surface reddening of the skin. The skin is unbroken and the wound is superficial. This would be a light sunburn or a first degree burn as well as a beginning Decubitus ulcer. The burn heals spontaneously or the Decubitus ulcer quickly fades when pressure is relieved on the area.

The key factors to consider in a Stage I wound is what was the cause of the wound and how to alleviate pressure on the area to prevent it from worsening. Improved nutritional status of the individual should also be considered early to prevent wound worsening. The presence of a Stage I wound is an indication or early warning of a problem and a signal to take preventive action.

Treatment consists of turning or alleviating pressure in some form or avoiding more exposure to the cause of the injury as well as covering, protecting, and cushioning the area. Soft protective pads and cushions are often used for this purpose. An increase in vitamin C, proteins, and fluids is recommended. Increased nutrition is part of prevention.

Stage II
This stage is characterized by a blister either broken or unbroken. A partial layer of the skin is now injured. Involvement is no longer superficial.

The goal of care is to cover, protect, and clean the area. Coverings designed to insulate and absorb as well as protect are used. There is a wide variety of items for this purpose.

Skin lotions or emollients are used to hydrate surrounding tissues and prevent the wound form worsening. Additional padding and protective substances to decrease the pressure on the area are important. Close attention to prevention, protection, nutrition, and hydration is important also. With quick attention, a stage II wound can heal very rapidly.

A wound can appear to be a Stage I wound upon initial evaluation, and actually be reevaluated as a Stage II wound during the course of care. Quick attention to a Stage I Decubitus ulcer or pressure wound will prevent the development of a Stage III Decubitus ulcer or pressure wound. Generally Decubitus ulcers or pressure wounds developing beyond Stage II is from lack of aggressive intervention when first noted as a Stage I. [see notation].

Stage III
The wound extends through all of the layers of the skin. It is a primary site for a serious infection to occur.

The goals and treatments of alleviating pressure and covering and protecting the wound still apply as well as an increased emphasis on nutrition and hydration.

Medical care is necessary to promote healing and to treat and prevent infection. This type of wound will progress very rapidly if left unattended. Infection is of grave concern.

Stage IV
A Stage IV wound extends through the skin and involves underlying muscle, tendons and bone. The diameter of the wound is not as important as the depth. This is very serious and can produce a life threatening infection, especially if not aggressively treated. All of the goals of protecting, cleaning and alleviation of pressure on the area still apply. Nutrition and hydration is now critical. Without adequate nutrition, this wound will not heal.

Anyone with a Stage IV wound requires medical care by someone skilled in wound care. Surgical removal of the necrotic or decayed tissue is often used on wounds of larger diameter. A skilled wound care physician, physical therapist or nurse can sometimes successfully treat a smaller diameter wound without the necessity of surgery. Surgery is the usual course of treatment. Amputation may be necessary is some situations.

Stage V
This is an older classification and not now used in all areas. A stage 5 wound is a wound that is extremely deep, having gone through the muscle layers and now involves underlying organs and bone. It is difficult to heal. Surgical removal of the necrotic or decayed tissue is the usual treatment. Amputation may be necessary is some situations.

Notation
It is possible for a wound to "go from a stage I wound to a stage III or IV" without the intermittent stage[s] being observed. All wound stages were present just not obvious, hence the need to treat all wounds as serious with the potential of rapidly worsening.

Nursing home abuse and neglect are often the cause of decubitis ulcers. When a nursing home facility provides a sub-standard level of care by failing to prevent decubitis ulcers, or neglecting to avoid the causes, patients can suffer serious and life threatening injuries. At least 60,000 people die from the complications and causes of decubitis ulcers each year in the United States. People who are vulnerable to developing decubitis ulcers must be frequently moved to avoid development of these sores, and adequately cared for in order to avoid serious injury. That means keeping the areas where pressure occurs (wherever the body rests with the most pressure in a bed - anything from heels and elbows to buttocks, shoulders, the back of the neck, the hips, even the side of the foot or leg. If a person can't move, they need a way to BE moved.

Prevention:

If bedridden or immobile with diabetes, circulation problems, incontinence, spinal problems, bone fractures, or mental disabilities, in addition to intensive care of the skin and keeping areas free from pressure - less than two hours in any given position for any part of the body-the patient should also be checked for pressure sores daily, especially every morning. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters. In addition, take the following steps:

Change position at least every two hours to relieve pressure.

Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores.

Eat healthy, well-balanced meals with extra vitamin C, if possible. Vitamin C helps build tissues..

Exercise daily, including range-of-motion exercises for immobile patients.

Keep skin clean and dry. Persons with incontinence need to take extra steps to limit moisture

THE NUMBER ONE CAUSE OF THE 100,000 LIMB AMPUTATIONS THAT OCCUR JUST IN THE US IS DECUBITIS ULCERS - the bedsore!

Chronic wounds remain inflamed and may take an inordinate amunt of time to heal - if at all.. These wounds are a major health problem in the United States and throughout the world. The most common chronic wounds are diabetic foot ulcers, venous leg ulcers, and pressure ulcers, although other wounds, such as surgical wounds, can also become a source of chronic non-healing.

Diabetic foot ulcers

Diabetics are prone to foot ulcers due to peripheral neuropathy: decreased sensation caused by this condition can result in a cut and trauma to the foot going unnoticed or can result in unusual pressures placed on the foot that are ignored. Diabetic foot ulcers are the most common chronic wound problem in the United States and the world. Some 25% of the 60 million diabetic patients in the United States develop foot ulcers - that's 15 million people--and approximately 100,000 limb amputations are performed in diabetic patients each year in the United States alone. It's an epidemic that has gone virtually unnoticed. It can happen to you.!

Venous leg ulcers
Venous leg ulcers are caused by a failure of valves in the veins of the legs, resulting in congestion and slowing of blood flow. Rubbing the legs downward increases the risk of vein failure in diabetics. Such ulcers occur spontaneously or in association with minor trauma to the leg. Venous leg ulcers can be very painful and can persist for more than a year. The older the patient, the more likely that venous leg ulcers will develop.

Pressure ulcers (decubitis ulcers or bed sores) result from pressure on skin, soft tissue, muscle, and bone that cuts off the ability of the capillaries to circulate blood for an extended period of time. The wounds that then develop occur in individuals unable to sense the pressure or who cannot change their body position to relieve the pressure. Pressure ulcers are a common and expensive problem in acute care, nursing home, and home care populations. In hospital settings the incidence of pressure ulcers has reached as high as 30% among those at risk.

Continue reading "Nursing Home Abuse and Neglect Is Often The Cause of Decubitus Ulcers, Bed Sores & Pressure Sores" »

Bed sores aka Pressure Sores and Decubitus Ulcers area commonly found in immobile patients who remain in one position for extended periods of time. The underlying mechanics behind the development of bed sores is that unrelieved pressure on areas of the body resulting in diminished blood flow to skin and muscle causing the tissue to die. As the tissue dies, a wound develops and in some situations, 'opens' exposing internal organs and bones. In addition to the pain and embarrassment that accompanies bed sores, studies have determined that patients with advanced bed sores are at a high risk for infection, sepsis and other complications says California Nursing Home Abuse and Neglect Lawyer Steven C. Peck.

What makes bed sores (also called pressure sores, pressure ulcers or decubitus ulcers) different from many other medical conditions is the fact that in most situations they can be prevented with the most basic care. Keeping patients clean, dry and alternating their positions greatly reduces the likelihood of patients developing the wounds. In order to prevent bed sores, facilities need to train staff on the techniques to prevent bed sores and and have adequate staff to assure there is enough manpower to implement the necessary care.

Many situations involving the development of bed sores during an admission to a medical facility give way to a claim or lawsuit against the facility. In the case of patients who have developed bed sores and subsequently died from the wound, the family of person may similarly be entitled to pursue to lawsuit premised on wrongful death.

Continue reading "Bedsore, Pressure Sores, Decubitus Ulcers Are Caused by Unrelieved Body Pressure" »

How do you know if your loved one is being neglected in a nursing home? When you go to visit, everything looks fine, but your loved one is unable to express his/her pain to you in words. When a nurses aide comes in to attend to your loved one, you noticed a big sore on the side of their leg. When you question it, the nurses aide claims that it is noting but a simple sore. This is wrong. What you are actually looking at are signs of neglect.

A decubitus ulcer is commonly known as a bed sore. A decubitus ulcer can be a simple red or pink mark on the skin or it can be as bad as a very deep sore that reaches into the bone or internal organ. They are caused by prolonged pressure on a particular part of the body and are seen on patients who are bedridden (Thus the name, bed sore).

Most nursing facilities have a policy to turn bedridden patients once every two hours in order to prevent decubitus ulcers from forming. If your loved one has these decubitus ulcers, then they are not being turned in the bed as often as required and this is a form of neglect in a nursing home.

These decubitus ulcers can lead to further complications, including death if not treated. Therefore, if you have seen decubitus ulcers on your loved one, you should first consult with the doctors and nurses in the facility. If they fail to respond or give you a reasonable answer to why there are decubitus ulcers on your loved one, then you should consider filing a report or a complaint for nursing home neglect.

The decubitus ulcer is often painful. So, your loved one may be in severe pain and unable to express their pain. They may be crying for help, but no one is listening. This is neglect. No one should have to suffer the pain of decubitus ulcers. Simply turning or repositioning your loved one every two hours will prevent these ulcers from forming. They should not be there in the first place, but if you do notice them, you should be informed that your loved one is experiencing some form of neglect in their nursing home.

It is true that decubitus ulcers are considered preventable and the development of decubitus ulcers is evidence of some form of neglect. Many paralyzed or terminal individuals with very poor nutrition can be free of these ulcers. This can be accomplished by good patient care.

Continue reading "Decubitus Ulcers, Pressure Sores & Bedsore Development Is Evidence of Neglect" »

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

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

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

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

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

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

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

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

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

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

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.

Self-Help for the Elderly and the Congress of California Seniors announced Tuesday (Dec. 8) that they have received $150,000 from the Verizon Foundation, the philanthropic arm of Verizon, to continue an elder-abuse awareness program for senior citizens in Santa Clara and Ventura counties.

Including this contribution, Verizon has awarded a total of $300,000 to the organizations for the Commitment to End Abuse of Seniors and Elders program (CEASE).

Through the program, Self-Help for the Elderly and the Congress of California Seniors have partnered with local senior service providers and domestic violence prevention groups to implement an education and outreach campaign, publish multilingual education materials, and direct information about local resources available to victims and family members.

"Our seniors are very vulnerable and we must make every effort to protect them," said Anni Chung, president and CEO of Self-Help for the Elderly. "I look forward to working with the Congress of California Seniors and Verizon to educate the public and families about the effects and consequences of elder abuse."

Hank Lacayo, president of the Congress of California Seniors, said, "In recent years, financial abuse, physical assault and family-related violence have increased while public resources to identify abuse and to protect victims have been cut back, creating a budget crisis for agencies fighting abuse. The continued funding from Verizon will help us prevent ongoing abuse and raise awareness of this critical issue through advocacy, education, training, public awareness and coordination of services."

State Sen. Leland Yee said, "While our resources are shrinking, the need for these types of programs is growing. As a result, this help is more important than ever. It is these community partnerships that are truly making a difference."

Every year, nearly a quarter of a million Californians are victims of elder abuse and dependent adult abuse. It is estimated that one of every 20 California elders is a victim of neglect or physical, psychological or financial abuse, according to the California Department of Justice, yet only one in five of these cases is reported.

Raising awareness of domestic violence and aiding in its prevention is a key social issue for the Verizon Foundation.

"Our senior citizen population is among the most vulnerable when it comes to the issue of abuse," said Elva Lima, Verizon vice president, strategic programs. "This partnership allows Verizon to continue to use our resources to support an organization that has a proven record of creating positive change in the lives of our seniors."

About Self-Help for the Elderly
Originally created as a "War On Poverty" program, Self-Help for the Elderly began serving seniors in San Francisco's Chinatown community in 1966. It provided social services and hot meals to low-income and isolated elderly. Today, Self-Help for the Elderly serves over 25,000 seniors each year in San Francisco, San Mateo, Santa Clara and Alameda counties. It is a multi-service organization providing programs along a wellness continuum ranging from employment/training and social activities for those who are more independent to in-home assistance and residential board and care to those who are frailer.

About Congress of California Seniors
The Congress of California Seniors (CCS), founded in 1977, is a statewide nonprofit advocacy organization and is registered with the IRS as a 501(c)(4) California corporation. Our board of directors is comprised of senior leaders and advocates from among the Congress of California Seniors' 105 affiliated organizations. The organization is funded through membership dues, contributions from affiliated organizations, individual donations and corporations.

Continue reading "Verizon Sponsors Elder Abuse Awareness Programs" »