- Class AA: $25,000 to $100,000 fine
- Class A: $2,000 to $20,000 fine
- Class B: $100 to $1,000 fine
The significance and severity of the violation determines the citation class and the amount of the imposed fine. Although several facilities were issued citations, the following three are examples of the most egregious.
Palm Terrace Healthcare and Rehabilitation Center
The Palm Terrace Healthcare and Rehabilitation Center in Laguna Hills was fined $75,000 for actions relating to the death of a resident. Despite observing the resident to be tired and lethargic, the staff allowed her to eat alone in her room. The resident choked on a piece of meat; she was hospitalized and died three days later. At the hospital, it was discovered that the patient had overdosed on morphine despite the lack of a prescription from her physician. The autopsy revealed that there were very high levels of morphine in her blood, and the coroner concluded that she had been dosed over a period of time prior to the choking. The coroner also concluded that there was a high probability that the morphine played a role in her choking. The police homicide office investigated the incident and could not determine who had administered the morphine to the patient. The CDPH determined that Palm Terrace failed to identify the patient’s care needs which resulted in the resident’s death and issued a Class AA citation.
The Springs at the Carlotta in Palm Desert
The Springs at the Carlotta in Palm Desert was fined $100,000 by the California Department of Public Health (CDPH). The Springs was also issued an “AA” citation. The CDPH concluded, after an investigation, that inadequate care led to the death of an 87-year-old resident in June of 2006. It concluded that the Springs failed to “identify the care needs” of the patient “based on an initial and continuing assessment.” This failure by the nursing home “presented an imminent danger” to the patient “and was the direct and proximate cause of death.” The resident had been admitted with a diagnosis of potential constipation (among other things). The facility was supposed to monitor and record the resident's bowel movements. The facility failed to properly monitor the bowel movements. After several days, the resident was vomiting and her abdomen was distended. She was transferred to a hospital where she died that same day of “Acute Peritonitis due to perforated colon due to severe constipation.”
Marysville Care Center
The Marysville Care Center in Yuba City was issued a Class AA citation and a $100,000 fine relating to the death of an 84 year old resident. She had been diagnosed with osteoarthritis, psychosis, and Alzheimer's disease and was totally dependent on the facility for her daily living needs. The CDPH reported that the facility failed to keep the resident “free from accident hazards” by not to putting down the side rails on the resident's bed. These side rails were to be used only when the resident was being turned. The report also indicated that the facility did not use a bed alarm that would notify staff if the resident attempted to get out of bed. The resident was found with her chin resting on the lower part of the bed rail with her feet on the floor. Her head was stuck between the bed rail and the bed. She was unable to free herself and choked to death.
Neglect and Elder Abuse
These three incidents of neglect are all examples of elder abuse. When visiting a loved one at a nursing home, be on the lookout for signs of neglect such as poor hygiene, dirty fingernails, signs of feces or smells of urine, unexplained weight loss, and bedsores. Facilities with staffing problems are especially prone to neglect. Staffing problems lead to high staff turnover and inadequately trained or inexperienced staff.
Thanks for reading. If you have a question or comment, feel free to reply to this posting, or send me an e-mail. If you suspect a nursing home's negligence or neglect has resulted in the injury or death of a loved one, contact me for help and immediate assistance.
