Elder Abuse Occurs Even in Luxury Care Facilities

Overall, between 2005 and 2006, the California Office of the Attorney General reports that there were 108 criminal filings and 60 convictions for elder abuse, and 25 civil complaints filed and 22 civil judgments for elder abuse. For both criminal civil cases, $4,806,652 was awarded in between 2005 and 2006 in restitution and penalties.

The families of those in nursing homes must continually observe their loved ones to prevent abuse. The California Attorney General’s Crime and Violence Prevention Center provides some indicators for possible abuse:

• Physical indicators include unexplained bruises or welts, poor skin condition or poor skin hygiene, untreated medical conditions, the presence of cuts, pinch marks, skin tears, lacerations or puncture wounds, or the existence of bruises or welts in various stages of healing.


• Behavior indicators include confusion, withdrawal, fear, or anger.


• Social indicators interaction or activity within the family that is restricted or prohibited, or an elder not being given the opportunity to speak for him or herself or see others without the care-giver present.


• Financial indicators include a lack of amenities, such as TV, personal grooming items, or appropriate clothing.
  

More information on the warning signs for elder abuse can be found at http://www.safestate.org/, the California Attorney General’s Crime and Violence Prevention Center.

Elder abuse can occur even in luxury care facilities. When Elmore Kittower, an 80 year-old occupant of Silverado Senior Living in Calabasas, California, passed away, his death was not initially deemed suspicious. Mr. Kittower was paying $75,000 a year to reside at Silverado Senior Living. Shortly after his death, Mr. Kittower’s widow, Rita, was contacted by a woman that claimed to be a Silverado employee. The woman told Mrs. Kittower that her husband had been beaten and suffocated by another employee at the nursing home. This led to a Los Angeles County Sheriff’s Department investigation and a finding that the trauma to Mr. Kittower’s body was similar to that of an assault.

Since Mr. Kittower’s death, the investigation of possible elder abuse at Silverado expanded. Authorities examined the possible abuse of three other residents of the nursing home. In an autopsy on Mr. Kittower, it was revealed that he died due to a lung blood clot. The report also stated that “blunt force trauma” was a factor in his death. Mr. Kittower’s body also had multiple bruises and showed evidence of a partially healed rib fracture. Another resident alleged to have been harmed is the mother of Keith Stubbs. Stubbs learned from authorities that his mother’s chest was jumped on. Stubbs said he did not suspect that his mother had been abused. In retrospect, Stubbs noted that he started seeing bruises on his mother’s arms and neck, and that he recently noticed that his mother recoiled when she was touched by visiting loved ones, something she had not done previously. The other possible victims are Silverado residents, Richard McDonough and Robert Turner. Authorities have said that Turner was punched in the stomach.

A former Silverado caregiver, Cesar Ulloa, has been implicated in the investigation. Ulloa has been charged with four counts of elder abuse and one count of torture. Ulloa was arraigned this week in Los Angeles Superior Court. He entered a not guilty plea.

Silverado spokesman Mark Mostow said that the company screens its potential employees and conducts background checks. He also said that all employees undergo an elder-abuse reporting program conducted by the California Department of Justice. Mostow indicated that Ulloa, who Silverado fired last year, appeared to have a friendly and outgoing demeanor and that families of the residents of Silverado received him well.

The Silverado case illustrates that even expensive facilities are not immune from elderly abuse. If you have a loved one in a nursing home or care facility, visit frequently and be alert for signs of possible abuse.

Thanks for reading my blog. If you have a comment or question, please feel free to reply to this posting, or send me an e-mail. If you suspect that a loved one has been the victim of elder abuse, contact me to schedule a confidential consultation and for immediate assistance.

New Elder Abuse Laws Signed by Governor Schwarzenegger

California Governor Arnold Schwarzenegger signed into law this week several bills aimed at curbing elder abuse and providing greater protection for the elderly in the State of California. Here is a brief summary of the new laws:

AB 2100 requires ombudspersons at long-term care facilities to report cases of alleged or suspected physical abuse, including sexual abuse, and financial abuse to the local district attorney’s office. The purpose of this bill is to encourage the reporting of suspected cases of abuse.

SB 1140 extends the statute of limitations for a claim for damages due to financial elder abuse to four years from the plaintiff discovers, or should have discovered, the abuse. Presently, the statute of limitations on such a claim is three years. In addition, the definition of financial abuse of an elder is expanded to include the action of taking, appropriating, obtaining or retaining, real or personal property by undue influence.

SB 1136 makes it a misdemeanor to charge an “unconscionable fee” to qualify a person for a public social service benefit, including Medi-Cal.

AB 225 extends the protection of a restraining order to include named family members, household members and conservators of the elder abuse victim.

AB 2149 regulates the use of “expertise” designations and requires advisors to take training courses before holding themselves out as having specialized knowledge regarding the financial needs of seniors. The bill is designed to prevent the elderly from falling prey to unscrupulous financial advisors who claim to be experts on financial planning for the elderly.

Also signed into law were two bills targeting nursing home and residential care facilities. AB 2370 requires residential care facilities to post information regarding recent rate increases on an annual basis, and also requires the disclosure of rate increase information to new residents, and, upon request, to prospective residents. AB 749 requires residential care facilities to have a comprehensive emergency plan by March 1, 2009 that provides that the facility will be self-reliant if necessary for at least 72 hours. The plan must be available to residents and emergency personnel.

The new laws are designed to protect the elderly in the event of a disaster and protect them from financial elder abuse.

Thanks for reading my blog. If you suspect that a loved one has been the victim of elder abuse, contact me to schedule a confidential consultation and for immediate assistance.

Too Many Patients, Not Enough Staff

A $2 million settlement on a class-action lawsuit filed against the corporate owner of nursing homes in Southern California was announced this week. The lawsuit was filed on behalf of residents at one of the facilities owned by Brea-based Sun Mar Healthcare, Inc., which owns 17 nursing homes. The lawsuit alleged that Sun Mar defrauded residents and violated health and safety codes. Sun Mar officials allegedly promised residents a level of care they knew they couldn’t provide, given their level of staffing. A spokesman from the California Advocates for Nursing Home Reform stated that nursing homes are not precluded from taking on more patients than they can adequately provide for, a practice the organization deems tantamount to fraud.

Inspection and investigation records obtained during the course of the lawsuit indicated that one of Sun Mar’s homes had 77 health and safety violations from 2004-2008. Nursing home advocates strongly recommend that you thoroughly research a home’s history of health and safety violations with the California Department of Public Health. They also suggest that you ask about the staff to resident ratio. Spend some time observing the staff interaction with residents. Does it appear that call bells and resident requests are responded to in a timely manner? Does there appear to be adequate staffing for the number of residents?

Other observations you should make regarding the staff during your visit include the following:

• Do staff members treat the residents with dignity and respect?
• Do staff members speak directly to the residents, or do they treat them as if they were not present?
• Do staff members respect the privacy of residents? Do they knock before entering?
  Do the nurses and administrators know the residents?
• Is everyone friendly and receptive to questions?
• What languages does the staff speak in addition to English?
• Does the facility conduct background checks on staff prior to hiring?
• Are there therapists on staff or does the facility contract out for therapists?
• Is there a social worker on staff? Full or part-time?
• Are there permanent full-time nurses and nurse assistants (CAN’s) on staff? Or registry nurses and aides?

Keep in mind these are simply some of the observations you will want to note during your visit. Inadequate staffing has a direct impact on the quality of care received. Nursing homes promise to provide a high standard of care, but often fail to do so. Understaffed facilities have higher incidences of pressure sores, falls and other injuries.

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 loved one has been harmed by negligence, neglect or abuse in a nursing home, contact me for immediate assistance.

California Nursing Homes’ Use of Restraints Highest in United States

Federal Nursing Home Reform Act of 1987
The Federal Nursing Home Reform Act of 1987 mandates that nursing homes receiving Medicare or Medicaid must adhere to the Nursing Home Patients Bill of Rights (NHPBR). One of the rights enumerated in the NHPBR is the right to be free from unreasonable restraints. 42 CFR 483.13, subsection (a) of the Federal Code states that nursing home residents have “the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.” To view the entire statute, click the following link: http://a257.g.akamaitech.net/7/257/2422/16nov20071500/edocket.access.gpo.gov/cfr_2007/octqtr/42cfr483.13.htm

Nursing Home Restraints Since 1987
Since the passing of the Federal Nursing Home Reform Act of 1987, overall use of restraints in nursing homes has declined. From the period from 2002 through 2006, their use has decreased almost 40%. The Federal Agency for Healthcare Research and Quality reported that in 2002, 9.7% of nursing home patients across the United States were repeatedly restrained compared to 5.9% in 2006. Some states did not fare very well; California nursing homes were among the worst offenders. The same study found that 13.4% of patients in California nursing homes were repeatedly restrained. To read the entire study, please click the following link: http://www.ahrq.gov/news/press/pr2008/snapshot07pr.htm

Of course, not all nursing homes in California have such a dismal record. Some are better than others. However, you may not have much to determine which nursing home is best for you or a loved one since you may have as little as 24 hours after a stay in the hospital to choose the right home. To help find the right place, the AARP has published a list of ten essential tips when choosing a nursing home. To view the list, click the following link: http://www.aarpmagazine.org/health/embedded_sb.html

Even if you do your due diligence when selecting a home, your loved one may still be exposed to potential risk of restraint related injury. It is important that you make regular visits to make sure things are going well.

Restraint Injuries
Sometimes a nursing home will restrain a resident to prevent a fall and to prevent injury to the resident. Bed rails are often used to keep residents from rolling out of bed and other restraints may be used to keep the resident seated in a chair. Many times these restraints are used out of laziness and often result in injury to the resident. Nursing homes have been known to use belt restraints, vest restraints, mittens, and wrist restraints.

Bed rails and other mechanical restraints such as straps and tie-downs are designed to limit mobility. If used incorrectly or when not warranted, they can be the cause strangulation and death. Misused mechanical restraints can also cause bed sores (pressure ulcers), incontinence, and confusion. A restrained resident might also suffer from loss of strength, emotional distress and depression.

Nursing home restraints should only be used if a doctor determines that they are necessary. They should not be used to cut costs at the nursing home. If loved one has been unreasonably restrained and has suffered injuries, you should contact a lawyer immediately to protect his or her rights.