California Nursing Home Abuse Lawyers Blog

Blumenthal, Whitehouse, Franken, Casey Introduce Elder Protection and Abuse Prevention Act

(Washington, DC) - Senator Richard Blumenthal (D-CT), Senator Al Franken (D-MN), Senator Sheldon Whitehouse (D-RI), and Senator Robert Casey (D-PA) introduced the Elder Protection and Abuse Prevention Act, a bill to implement a comprehensive network of elder abuse prevention and response measures says California Nursing Home Abuse and Neglect Lawyer Steven Peck.

"A spreading epidemic of seniors who are abused or exploited by family or caregivers must be stopped," said Blumenthal. "Rigorous screening and reporting to detect and deter abuse, physical or financial, is necessary to help remedy seniors who may be too fearful or embarrassed to report it themselves. This measure would require tough national standards for screening and reporting so wrongdoers can be stopped and prosecuted. There is no excuse for one in ten seniors continuing to suffer the physical injury, emotional anguish and anxiety, and financial hardship, costing upwards of $3 billion every year."

"Our nation's seniors deserve the peace of mind of knowing that they are protected from physical and emotional abuse and financial exploitation," said Whitehouse. "I am proud to be an original cosponsor of this bill, which would strengthen and improve State programs to better prevent and address elder abuse."

"Across the country, far too many seniors are being abused or exploited by the very people who should be looking after their wellbeing," said Sen. Franken. "This bill will address the tragedy of elder abuse - which is far too prevalent in Minnesota and across the country - by providing resources to protect seniors from abuse and help those who have already been abused."

"We must bring this largely silent epidemic of elder abuse to an end", said Senator Casey. "We have an obligation to protect our parents and neighbors who have helped build our Nation. This bill is an important step in the right direction in stopping the abuse and neglect of our older citizens."

While child abuse and domestic violence screenings are well-integrated into the nation's health and community services network, elder abuse screening requirements are noticeably absent in federally-supported senior services. The Elder Protection and Abuse Prevention Act seeks to fill that void by encouraging the development of a strong network of elder abuse screening and support programs to identify instances of elder abuse and stop them before they happen. In some states, strong mandatory reporting laws and penalties exist for crimes against seniors, but they are ineffective without screening and reporting standards in every part of our community.

Specifically, the bill would:

Toughen federal standards for abuse - toughens the federal definitions for elder abuse, neglect and exploitation, streamlining the definitions for elder abuse between the Elder Justice Act and the Older Americans Act (OAA). The Act also defines Adult Protective Services (APS) in the Older Americans Act, the only victim services resource for adults with the authority to act on reports of abuse. The bill defines financial exploitation for the first time in federal statue, and adds victims or alleged victims of abuse and exploitation to a list of conditions eligible for priority for social services under the Older Americans Act.

Improved Coordination of all Elder Justice Activities - requires that the appropriate training and prevention and provision of elder justice throughout the OAA Programs are routinely updated as necessary and sees to the full integration of elder justice activities with all social services programs under the Act.

Authorization of the National Adult Protective Services Resource Center - codifies the National Adult Protective Resources Center in the Administration on Aging, and expand both its guidance and responsibilities to states.

Requires the development of best elder abuse screening practices - directs the National Adult Protective Resources Center to support states in the development of best practices to incorporate elder abuse screening into health and wellness services and would require the research center to study and disseminate this information to states regularly.

State prevention, assessment, and response to elder abuse - incorporates elder abuse prevention training, screening, and reporting protocol into all senior service access points that receive federal dollars under this bill as part of their state and area plans on aging

Improvement of training for elder justice activities -incorporates the research and replication of successful models of elder abuse, neglect, and exploitation prevention and training into the Older Individuals' Protection from Violence Projects and strengthens Elder Justice sensitivity training requirements.

In 2009, there were 6 million instances of elder abuse reported nationwide, and only 23.5% of cases are reported due to a lack of screening, awareness, and prevention efforts. It is estimated that seniors lose a minimum of $2.9 billion each year to financial abuse and exploitation and victims experience a mortality rate of three times higher than those who are not victims of elder abuse.

Continue reading "Senators Introduce Elder Protection and Abuse Prevention Act to Curb and Prevent Elder Abuse in the United States" »

Sepsis and septic shock can result from an infection anywhere in the body, including pneumonia says Nursing Home Abuse and Neglect Lawyer Steven Peck. It is known that in the United States, health care-associated infections (HCAI) affect 1.7 million hospitalizations every year. And, the two most common conditions are sepsis and pneumonia. In February 2010, a study published in the Archives of Internal Medicine, confirmed the high costs resulting from caring for patients: an more than $8.4 billion per year. In addition to this, the study found that such infections cost an average of an extra 11 days in the hospital and $33,000 dollars, per person.

Sometimes called blood poisoning, sepsis is the body's often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.

Worldwide, one-third of patients who develop sepsis die. Almost 20% of patients who develop sepsis after surgery die. Many who do survive are left with organ dysfunction and/or amputations.

The most common source of infection, among adults, is the lung or lungs.

Continue reading "Nursing Homes and Long Term Care Facility Infections May Lead to Sepsis and Septic Shock Says Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Effective prevention and treatment measures depend on a comprehensive care plan that includes scheduled turning and body repositioning in order to stop the incidence of Bed Sores, Pressure Sores and Decubitus Ulcers says Nursing Home Abuse and Neglect Attorney Steven Peck. There is evidence that the frequency and intervals between turnings may be more critical than pressure in the production of pressure ulcers. Tthe practice of turning patients every 2 hours, and this procedure remains the mainstay of prevention strategies. Various other factors clearly contribute to the development of pressure ulcers. However, the best advice still is to establish a regimen in which pressure is completely relieved on all areas of the body at regular intervals.

Providers working with persons at risk need to be able to recognize skin changes that might indicate an impending breakdown. This is particularly true in elderly patients or in patients who are immunocompromised because the signs of impending or fulminating infection are frequently absent in these patients. Systemic signs of infection that mark the need to culture wounds include drainage, leukocytosis, fever, hypotension, increased heart rate, and changes in mental status. Prevention of progression to more serious damage requires immediate, complete elimination of pressure to the involved area.

If the proposition that pressure in excess of normal is the chief cause of pressure ulcers is accepted, then the primary prevention efforts have to be directed toward reducing or eliminating pressure over susceptible areas. The intensity and duration of external pressure and shearing forces necessary for pressure ulcers, bed sores and decubitus ulcers to occur depend on an individual's susceptibility, which could be summarized as their tissue tolerance. Nursing strategies include prevention of prolonged pressure, elimination of shearing forces and friction, and removal of skin secretions and excretions.

Statistically, 21.2% of patients who underwent surgery for more than 4 hours developed 70 pressure ulcers in the first 2 days following surgery. Twenty-one pressure ulcers, bed sores and decubitus ulcers deteriorated in the days following surgery. More than half (52.9%) of the lesions developed on the heels, and 15.7% developed in the sacral area.

Additional interventions that may be indicated for patients most at risk for pressure ulcers, bed sores and decubitus ulcers include avoiding hot water; using a mild cleansing agent that does not irritate or dry the skin; using moisturizers; using topical agents such as moisture barriers; keeping the sheets dry and wrinkle free; providing adequate intake of protein and calories; and maintaining current levels of activity, mobility, and range of motion. Massaging body prominences should also be avoided since this practice has been associated with increased tissue breakdown and risk for the formation of pressure ulcers.] Positioning devices such as pillows or foam wedges should be used to prevent direct contact between bony prominences (eg, knees, ankles). Donut-type devices should not be used because they are known to cause venous congestion and edema.

Continue reading "Comprehensive Care Plans Must Be Instituted to Halt the Incidence of Bed Sores, Pressure Sores and Decubitus Ulcers says Nursing Home Abuse and Neglect Attorney Steven Peck" »

Mandatory reporting of Elder Abuse is very important. There are several comparisons being made to elder abuse, child abuse & domestic violence when it comes to this issue.

It is not uncommon for a victim of either Domestic violence or elder abuse to contact our office and demand or plead that we should not file a civil complaint or restraining order against the abuser.

As Nursing Home Abuse and Neglect and Elder Abuse Lawyers the Peck Law Group will file and litigate these claims.

If we conclude that we have sufficient evidence to prove our case, we will move forward and hold the elder abuser accountable.

We need our ER nurses, paramedics, APS case workers, police officers, bank tellers, caregivers, clergy and the like to step forward and report their observations - without fear of repercussion.

Continue reading "Mandatory Reporting of Elder Abuse Shall Help Hold the Elder Abusers Accountable" »

A pressure sore, or decubitus ulcer, is skin damage in the form of a wound resulting from continuous pressure. Usually these sores form over bony prominences, such as your elbows, heals, and sacrum. Elders are most susceptible, though any person who is unable to reposition his or her body is vulnerable to pressure sores.

Other factors that can contribute to compromised skin integrity are moisture, such as sweat or feces; traction, such as skin being stuck to the sheet and then pulled away; and ill-fitted adaptive equipment, such as a tight splint.

Pressure sores develop from reddened patches, when initial irritation begins. These areas sometimes become white when the blood supply is cut off from the skin tissue, also called ischemia. Lastly, the sore opens. Pressure sores can be extremely difficult to heal once they are open, which is why they should be addressed immediately upon discovery, regardless of what stage they are in. It is much easier to keep a pressure sore from developing than to heal one that has begun.

Continue reading "A Pressure Sore, Bed Sore or Decubitus Ulcer, Is Skin Damage in the Form of a Wound Resulting From Continuous Pressure" »

Senator Juan Vargas' Senate Bill 718 was signed into law on Friday, September 30, 2011. The new law, effective January 1, 2012, will authorize counties across the State of California to offer a confidential internet system for reporting instances of elder abuse.

"This bill provides an important tool to ensuring the safety of our seniors," said Nick Macchione, Director of the County of San Diego Health and Human Services Agency. "By providing our mandated reporters, such as law enforcement and financial institutions, the ability to submit prompt and complete reports online, SB 718 will enable our staff to quickly address situations that put our most vulnerable residents in danger."

Currently, mandated reporters, such as licensed health practitioners, must report instances of elder abuse in a timely manner. Due to the high volume of callers and a recent decrease in personnel due to budget cuts, there can be a lengthy wait before a call is answered on the county's main elder abuse reporting phone line which handles calls from mandated reporters and the general public. In November 2010, it was determined that 27 percent of callers hung up rather than waiting on the line to report abuses, leaving seniors and dependent adults at further risk of abuse.

The secure internet system would require that mandated reporters provide the same information as required in writing or over the phone. This service would be made available at no additional cost to the State of California.

"Today, we scored a victory in protecting seniors from elder abuse! Establishing a confidential internet reporting system is a common-sense step to protect seniors and dependent adults," stated Senator Juan Vargas (D-San Diego). "This effective reporting system will ensure that our seniors' voices are heard and abuses are not overlooked."

Continue reading "Governor Signs Elder Abuse Reporting Bill into Law " »

This is the story of a ninety-two-year old man who went to a skilled nursing facility after a hospital stay for shortness of breath. He died several days later from pressure ulcers on his heels that led to leg amputations and a raging bone infection.

Apparently nursing home staff had not repositioned him often enough. Court depositions showed that the nursing home administrator and a representative of the facility's corporate offices had ordered a nurse to alter the medical records to show that the resident had arrived at the facility with "softened heels." But the nurse admitted she had not seen the patient when he was admitted and had "no memory of him ever having softened heels." The nurse said a corporate representative had told her "to falsify the medical records because the current records did not 'look good' and he was worried about a lawsuit." says Nursing Home Abuse and Neglect Lawyer Steven Peck.

Fraudulent charting is often the result of understaffing: "public documents reveal tales of chaotic shifts on which certified nurse assistants are scrambling to provide care." Since nursing staff is a facility's biggest cost, it's easy to see how fewer nurses makes good business sense, especially when doctoring the records appears so easy.

Continue reading "Nursing Homes Are Chronically Understaffed leading to the Falsifying of Medical Records" »

Lower urinary tract infections (UTIs) are a major cause of morbidity and mortality for adults in long-term care (LTC).1 Community studies have shown prevalence rates of bacteriuria to be 11% in the elderly, 18% for those living in congregate living arrangements, and 25-50% for residents in nursing home environments. In fact, the most common cause of bacteremia in LTC residents is due to UTIs.

The prevalence of UTI increases in both sexes with age, resulting in a female-to-male ratio of 2:1 in the elderly population. The annual incidence of symptomatic bacterial UTIs is estimated to be as high as 10%. For asymptomatic bacteriuria, the estimated cumulative prevalence is 30% in women and 10% in men. Interestingly, the female-to-male ratio in the incidence of UTI narrows in the elderly population, which is thought to be related to the fact that with increasing age, men develop an increase in residual urinary volume after voiding, which increases their risk of bacteriuria and UTI; women engage in less sexual activity with age, and thus have one less predisposing risk factor for introduction of bacteria into the urinary tract.

Bill Update: SB 558 (Simitian) was approved by the Senate by a vote of 21 to 14. The bill recently passed the Assembly Judiciary Committee by a vote of 7 to 3, and now awaits a hearing in Assembly Appropriations.

The Consumer Federation of California supports SB 558 (Simititan) because it would allow elder abuse to be enforced using a preponderance of the evidence standard.

As the bill author noted, "It is estimated that over 132,000 elders in California are abused every year. However, for every abuse reported, research has found that at least 5 others go unreported, making the actual number of abused people much higher than the reported rate. Studies show that neglect and abuse of nursing home residents have reached epidemic proportions. A report by the Centers for Medicare and Medicaid Services found that at least 91% of homes have been cited for health and safety deficiencies. Yet many residents who suffer neglect and abuse find it virtually impossible to seek justice in court."

This bill will strengthen protections for California's most vulnerable consumers: seniors. SB 558 (Simitian) will empower elderly adults and their advocates to pursue necessary legal protection.

Current law provides elder abuse civil cases are litigated with a higher legal standard than what is used in civil financial abuse cases: clear and convincing evidence. This bill would correct this anomaly, and give seniors and senior advocates a more appropriate, effective tool for holding elder abusers accountable.

Continue reading "SB 558 Provides Necesary Legal Protection says California Nursing Home Abuse and Neglect Lawyer Steven Peck" »

One in 20 hospital patients get infections. In California, roughly 200,000 people get hospital infections annually, and 12,000 of them die, according to state Department of Public Health statistics. That makes such infections one of the state's leading causes of death, ahead of automobile accidents and Alzheimer's disease.

Yet these deaths have remained mostly in the shadows. They often are classified as "deaths from complications," an oblique term used in obituaries and often unquestioned by relatives and friends says California Nursing Home Abuse and Neglect lawyer Steven Peck.

Even the best doctors can be baffled whether an infection was acquired before or after a patient was admitted, and if it was the principal cause of death or no factor at all.

Many health care providers historically have viewed hospital infections - going by obscure names or acronyms such as C.diff, CLABSI, VRE and the more familiar MRSA - as a sometimes inevitable consequence of being hospitalized.

That has begun to change. Research has demonstrated that many hospital infections are preventable, and most hospitals, have launched campaigns to rid their facilities of infections.

The change has not come nearly fast enough for many of our loved ones who have died as a result of these facility acquired infections.

"Hospitals are in denial," Elder Abuse Attorney Peck says "Because the public does not have knowledge and understanding of C. difficile, a very potent infection. It is easy for the hospitals to sweep this serious situation under the carpet, and the relatives of the deceased are none the wiser."

Continue reading "Many To Many People Are Being Killed In Long Term Care Facility Acquired Infections Says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck" »

State Rep. Eugene DePasquale, D-York, said he voted for a bill last week that would protect care-dependent people from abuse and neglect.

House Bill 1053 would amend the Pennsylvania Crimes Code to include caretakers who intentionally or knowingly endanger the welfare of a care-dependent person in their care by failing to provide needed treatment, care or goods and services. Further, the bill would prohibit caretakers from physically or mentally abusing a care-dependent person.

"While I believe most caretakers are professional and conscientious about their care, this legislation seeks to deter abuse and hold those who violate care-dependent individuals accountable for their actions," DePasquale said.

DePasquale said care-dependent people may be elderly, disabled or have mental retardation. Private care residences are private residences whose owner or operator provides food, shelter, clothing and personal care or health care in the home to no more than three non-relatives.

"Because these operations are so small, they are not subject to inspection or held to the same stringent standards as larger facilities," DePasquale said. "Tragically, this had led to incidents, including deaths, which inspired this legislation."

Under H.B. 1053, a caretaker would commit the offense of abuse of a care dependent person if he harasses, annoys or unduly alarms the person. Among the actions that constitute abuse are physical harm, lewd or lascivious behavior and threats.

"Unfortunately, it seems the frequency of elder/disabled abuse is becoming greater as people live longer lives and more people are living to an age when they are vulnerable to those helping to care for them," DePasquale said.

The National Center on Elder Abuse reported a 150 percent increase in reported incidents of abuse to state adult protective services.

Continue reading "Legislation Against Caregivers Commmitting Elder Abuse is Warranted" »

Nursing homes are unnecessarily administering powerful antipsychotic drugs to many elderly residents, including residents with dementia according to a new report by the Health and Human Services inspector general says California Nursing Home Abuse and Neglect lawyer Steven Peck.

The Food and Drug Administration in 2005 mandated that drug makers issue warning labels on atypical antipsychotics, noting that the drugs--which are generally FDA-approved for treating schizophrenia and bipolar disorder--increase the risk of death for elderly patients with dementia. Yet when the government examined 1.4 million Medicare claims from 2007 for atypical antipsychotics for elderly nursing home residents, the government found that 88 percent of the time, the drugs were prescribed to individuals diagnosed with dementia indicates Los Angeles Elder Abuse Attorney Steven Peck.

Despite the fact that it is potentially lethal to prescribe antipsychotics to patients with dementia, there's ample evidence that some drug companies aggressively marketed their products towards such populations, putting profits before safety, says Peck.

Peck notes that a number of drug companies have been accused of illegally promoting these drugs off-label to doctors and pharmacies, including those that serve nursing home residents.

The report also faulted the Center for Medicare and Medicaid Services (CMS), the agency that oversees Medicare and Medicaid, for failing to hold nursing homes accountable for unnecessary use of antipsychotic drugs. Unnecessary uses can include inadequate rationale for using the drug as well as excessive doses, excessive duration, and inadequate monitoring of patients to whom the drug was given.

The report notes that the federal government paid more than $116 million for claims that violated Medicare reimbursement criteria. These claims were only for the first half of 2007.

The inspector general recommends that CMS assess its safeguards for preventing unnecessary antipsychotic drug use in nursing homes. The agency acknowledged that better controls were needed.

Continue reading "Nursing Home Residents Are Very Often Overmedicated Says San Diego Elder Abuse Attorney Steven Peck" »

An estimated 400,000 people die every year due to infections in US hospitals and nursing homes, according to a new study says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck.

Infections in nursing homes have become a leading cause of illness and death in the US, researchers from the University of Pittsburgh's Graduate School of Public Health said in the study published in the May issue of the American Journal of Infection Control.

The study examined the deficiency citation records used in Medicare/Medicaid certification between 2000 and 2007. The data represented 96 percent of all US nursing home facilities, Xinhua reported.

Nearly one in seven nursing homes is cited for deficiencies in infection control practices each year, the findings showed.

There is a strong correlation between low staff levels at these nursing homes and the receipt of an infection control deficiency citation, the researchers noted.

The high number of deficiency citations suggests there was a need for infection prevention programs to protect the elderly, according to the study.

The researchers said that when faced with staff shortage, nurse aides, licensed practical nurses and registered nurses are likely to rush and may cut corners on infection control measures, such as proper hand washing. according to Elder Abuse Attorney Peck.

A number of states have already enacted laws that apply to infection prevention practices in long-term care facilities.

Continue reading "Infections In US Hospitals Are Out of Control States California Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Prolonged sitting by a person in a wheelchair exposes that person to a high risk of
decubitus ulcers. Decubitus ulcers are lesions ranging from areas with "intact skin
with non-blanchable redness" (stage I) to full thickness tissue loss with exposed
bone, tendon or muscle" (stage IV) (National Pressure Ulcer Advisory Panel 2007).
We use the term "decubitus ulcer" rather than "pressure sore" or "pressure ulcer"
because, as explained in this article, pressure is only one of many factors leading
to formation of a lesion says Los Angeles Elder Abuse Attorney Steven Peck.

It is difficult for most people to understand the devastating consequences that
can result from decubitus ulcers. For a person who normally uses a wheelchair,
it can mean months of bed rest and hospitalization indicates San Diego

In addition, after a decubitus ulcer has healed, the skin never fully recovers.
Scarring, adhesions and tissue loss in the wake of a decubitus ulcer heighten
future risk. Finally, as a person ages, tissue and circulation gradually become
less resilient and viable.

Because of the effects of aging, the margin of safety for people using wheelchairs
narrows year by year, and the likelihood of something triggering a skin breakdown
increases. Decubitus ulcers can destroy careers, upend lifestyles, reduce
independence and lead to depression. They can ultimately lead to repeated
amputations reaching the trans-pelvic level. Septic conditions can be very
difficult to control and lead to death. Fifty percent of all admissions and 8% of
all deaths at specialized spinal cord-injury hospitals are due to decubitus
ulcers also known as pressure ulcers and bed sores.

Continue reading "Prolonged Sitting Exposes Elders and Dependant Adults to Decubitus Ulcers, Pressure Ulcers and Bedsores says Elder Abuse Lawyer Steven Peck" »

According to statistics in the State of California, elder abuse and neglect is certainly very underreported. Many institutions including assisted living and skilled nursing facilities are getting away with elder abuse and neglect says California Nursing Home Abuse and Neglect Attorney Steven Peck.

Clearly such unwarranted things that transpire in long term care facilities include infections, pressure ulcers also known as bed sores, dehydration, and malnutrition. Many of these items will also cause the death of a compromised elder.

Understaffing is also a major problem in these facilities and can be attributed to neglect and the lack of care causing serious personal injury.

Continue reading "Elder Abuse and Neglect Severely Underreported" »