Articles Posted in Assisted Living Facilities

If your loved one resides in a nursing home or assisted living facility, it is important to be on the lookout for signs of abuse and neglect.  Sadly, instances of abuse and neglect are not uncommon, and many elderly residents, especially those who suffer from cognitive issues such as dementia, are often unable to protect or speak up for themselves.  Unusual depression, confusion, isolation, and withdrawal, as well as unexplained bruises and injuries, and poorly-kept hygiene, are all major signs that an elderly resident may be the victim of neglect.

If you believe your loved one has actually experienced such abuse or neglect, it is also important to speak with a knowledgeable elder abuse attorney as soon as possible.  Some facilities have gone to great lengths to attempt to conceal any and all evidence of abuse, therefore it is in your best interests to contact an attorney to help you navigate your legal options sooner rather than later.

Here are five significant reasons why you may consider hiring a skilled elder abuse attorney to help you with a potential case:

Abuse and neglect in long-term care facilities for the elderly is usually difficult to notice.  Studies from the National Institute on Aging (NIA) indicate that as many as 1 in 10 elders experience some form of abuse each year, and figures from the World Health Organization (WHO) show that on average just 1 out of 24 cases of abuse are reported each year.

Some elders can also be at a greater risk of elder abuse based on a number of factors.  These include mental capacity, age, gender, and whether the elder resides in a community setting.  Multiple studies have corroborated that older adults with diminished psychosocial capacities, such as a diagnosis of a cognitive condition such as dementia or Alzheimer’s disease, increases the risk that the elder will be a victim of abuse, as these elders are likely unable to report the abuse or protect themselves.  The WHO and the Department of Health and Human Services additionally report that elders that are isolated, as well as elderly women, are also at a greater risk of abuse.

Although not all injuries that occur in nursing homes and assisted living facilities amount to abuse or neglect, it is important to be on the lookout for red flags and warning signs to abuse to better protect your loved ones during their residency.

On February 28, 2022, the White House announced new reform measures to better the quality of care and the safety of skilled nursing facility residents, as well as to “crack down on bad actors” operating nursing homes.   In his State of the Union address, President Biden called on the Centers for Medicare & Medicaid Services (CMS) to set and maintain higher standards for “sufficient staffing” of nursing homes.  CMS is now conducting research to determine the minimum level and type of staffing requirements needed and plans to propose rule changes to existing regulations within the year.  The effect of these policy changes is that skilled nursing facilities may face having federal funding pulled should they refuse to comply with these minimum safety standards.

California long-term care facilities are subject to a number of regulations governing the type, number, and training of staff at facilities caring for elderly adults.  For example, under federal law, a skilled nursing facility “must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care.”  (42 C.F.R. § 483.30.)  Similarly, under California law, a skilled nursing facility “shall employ an adequate number of qualified personnel to carry out all of the functions of the facility” (Health & Safety Code § 1599.1(a).)

It is well established that understaffing in nursing homes and assisted living facilities directly lead to substandard care.  Understaffing contributes to and can cause avoidable illness, injury, and death, and is positively correlated with elder abuse and neglect.  However, there is often a conscious decision by managers, directors, and administrators to understaff their facilities, with explicit knowledge that understaffing will negatively impact the overall quality of care provided to residents.  (See, e.g., California Watch, Nursing Homes Received Millions while Cutting Staff, Wages (July 29, 2011).)

Admitting yourself or a loved one to a nursing home or residential care facility can be a daunting process. You are often required to sign dozens of forms, and it may be difficult to understand exactly what you are signing when you are in one of the most hectic and stressful situations in your life.

Recently, more and more nursing homes and care facilities are slipping arbitration agreements into the stack of paperwork for you to sign upon admission. Although they may tell you that these agreements are “voluntary,” people often feel pressured to sign to make sure that they or their loved ones make it into the facility for necessary care without hassle, even though you may not completely understand the effects of signing a document filled with legal jargon. It is important that you refrain from signing these agreements and to get in touch with a Los Angeles elder abuse attorney if you need help.

What Are Arbitration Agreements?

Arbitration agreements are drafted by the nursing home’s lawyers with language that favors themselves. When you sign an arbitration agreement, you are signing away your constitutional right to bring a dispute, including an elder abuse and neglect claim, to be heard in court in front of a judge and a jury of your peers. Instead, you are agreeing to bring the dispute to an arbitrator, who is a private, independent person appointed to settle the matter.

Nursing homes and care facilities will tell you that arbitration is cheaper, faster, and more efficient than bringing a potential claim to a court of law. This is simply false, and an elder abuse attorney in Los Angeles may help if you are faced with signing, or have already signed, an arbitration agreement. Continue Reading

Falls are the most common injuries among the elderly. Nursing home residents are twice as likely to experience falls than non-residents, and falls have been linked to nearly 2,000 resident deaths per year. The elderly are also more prone to injury because of a high chance of having osteoporosis, which makes their bones very fragile, takes longer for them to heal, and makes them more vulnerable to infections.

Many falls are not reported by nursing homes or care facilities. Even though residents are, on average, older and more vulnerable than non-residents, most of these falls should be able to be prevented. It is important to know the causes of falls and how to prevent a fall injuring you or a loved one. Get in touch with a Los Angeles elder abuse lawyer if you or a loved one has fallen at a facility.

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Pressure ulcers are severe and sometimes life-threatening medical conditions that affect a high number of patients and residents living in nursing homes and assisted living facilities. Several studies show that as high as one-in-five patients and residents of these facilities have experienced signs of a pressure ulcer at some point in their admission.

Pressure ulcers are a form of elder abuse and neglect and are often caused by nursing home staff failing to care for the basic needs of a patient or resident. These injuries do not happen instantaneously. It is important to understand how to prevent pressure ulcers to ensure that you or your loved one is receiving the best medical care possible. Contact a Los Angeles nursing home lawyer if you believe that your loved one has been a victim of this type of neglect.

What Are Pressure Ulcers?

Pressure ulcers, which are also referred to as pressure sores or bed sores, are skin and tissue injuries caused by persistent pressure or friction to certain areas of the body. The most common areas for pressure ulcers are the back, buttocks, elbows, hips, heels, and ankles. Patients and residents with limited mobility, especially people in wheelchairs or who are bed-bound, have a greater risk for pressure ulcers than others because they typically spend long periods of time in one position.

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The consequences of lack of communication between hospitals and skilled nursing facilities (SNFs) are not new knowledge. According to a 2013 study, in the U.S. alone, more than 5 million patients transition from hospital to SNFs yearly. These transitions heavily rely on the thorough communication of healthcare professionals and paraprofessionals to ensure adequate care for patients. However, hospitals and local SNFs typically operate as separate entities causing a myriad of miscommunication. Communication issues that may happen between the facilities include incomplete, contradicting and/or mismatching verbal and written care plans. These problems may cause SNF staff to delay—or never deliver—proper care for patients, resulting in potentially fatal consequences. For example, noting the wrong medication can cause a stroke patient to relapse into another stroke and an avoidable hospital readmission. While many factors can be used as scapegoats to explain these mistakes, these problems are not new, and as professionals in the field, SNFs should establish better communication and points of accountability before accepting a patient to ensure the dignity and quality of care of patients. A recent study published by the Journal of the American Geriatrics Society by multiple medical doctors have indicated that a significant number of hospital readmissions from SNFs were likely preventable.

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As our population ages, there has been an increase in the number of elderly patients that undergo neurosurgical interventions. This increase is accompanied by aging risk factors, such as frailty, that increase the risk of complications post-surgery. A recent study undertook the task of surveying how recent falls affected patients who underwent a neurosurgical operation, focusing on a patient’s outcome relative to their fall history in the six months prior to their surgery.

The study’s overall findings were that patients with at least one fall six months prior to a neurosurgical procedure, had an increased risk of complications following their discharge. It specifically focused on the number of those discharged to a facility post-surgery, re-admittance rate, and the rate of complications. 18 % of those studied were discharged to a long term care facility after the operation, 17% were readmitted within thirty days, and 28% also had a complication arise within thirty days of their discharge date.

The results of this study give reasons to include fall history in preoperative risk assessments prior to any neurosurgery. While the frailty of an elderly patient is already considered in these assessments, it is important to include patients fall history since there reason to believe that these falls affect patients’ recovery. Neurosurgical procedures  As shown in the study there is a higher risk of complications that arise when a patient has suffered a fall.

Many people today use medication unnecessarily. The smallest flu or cold warrants the use of antibacterial medication that often does greater harm to our bodies. We ask our doctors for medications that cure common illnesses without thinking of the effects that these medicines may have on our bodies in the future. A rising concern in the medical field is the emergence of antimicrobial-resistant microorganisms (ARMs). Although resistance to antimicrobial organisms is a natural occurrence, over the years the cases of ARMs have been rapidly growing. The over-consumption and misuse of medication has created antimicrobial resistance on every continent.

An increasing worry is that soon common diseases, such as pneumonia and tuberculosis, will become fatal to those that acquire them. With an increased exposure to antimicrobial medicines, these diseases may continue to develop a stronger resistance to medications used now, creating a possibility that they may not work in the future. Resistant strains of bacteria are caused by inappropriate prescription of antibiotics when the patient truly doesn’t need them, or a misuse by the patient, for example stopping the use of the medication before the infection is fully treated. ARMs can cause post operation infections, result in limb loss, or complications in the central nervous system. A report  recently published by the OECD estimates that globally, at least 70,000 people die a year due to these resistant bugs.

Not only are ARMs a health risk, they have now become a financial burden. It takes hospitals more time, resources, and money to treat infected patients. The OECD report estimates that an additional 10,000 to 40,000 USD are spent treating patients infected by an ARM. In addition, global markets are also affected by these resistant microorganisms. In 2015 chicken sales in Norway dropped by 20% after news got out that a resistant strain of E. coli was found in the meat.

After the Wells Fargo scandal earlier this year in which the company admitted that its bankers created millions of fraudulent accounts, Wells Fargo is once again in the public eye for its attempt to stay out of courts by forcing the customers of these fraudulent accounts into closed door arbitration agreements. When existing customers were set up with fake accounts, they were entered into a new contract that required any disputes to be handled through arbitration and out of the court room. This new contract left existing customers dealing with an agreement that they never signed. The unfairness of this situation has left many customers without the legal rights to address the issue of fraudulent accounts in the court room or through a class action. Several Democrats have expressed their concern at the unfairness of these arbitration agreements and have advocated for legislation that provides remedies to those who were forced into these binding contracts without their consent. For example, California state Senator Bill Dodd introduced a bill to “override forced-arbitration clauses in contracts created through fraud”. This type of legislation would allow law suits to be brought against companies committing fraud despite the arbitration agreements in the customer’s contracts.

An editorial by the LA Times also disagrees with Wells Fargo’s ability to force their customers into arbitration for accounts their customers did not create, especially when these arbitration agreements are usually meant to favor the business rather than the consumer. Leaders such as Representative Brad Sherman and Senator Sherrod Brown have proposed similar bills to that of Senator Dodd’s, hoping to bar banks from requiring arbitration agreements in the future. Since these arbitration agreements are an attempt by Wells Fargo to stay out of the court room and settle disputes privately, the Consumer Financial Protection Bureau has proposed to prohibit banks from blocking future class action lawsuits brought on by customers. This will allow class actions to serve as a check on bank’s actions.

Similar to Wells Fargo’s practice of forcing their customers into arbitration agreements before doing business with them, some nursing homes and skilled living facilities also have their incoming patients sign into similar arbitration agreements before being admitted. These types of agreements are unfair to residents of these facilities since they are denied full legal remedies in the event that they are wrongfully treated. If their needs are not taken care of properly or they experience abuse and/or neglect residents with an arbitration agreement often find it difficult to pursue legal measures against the facilities that wronged them. These arbitration agreements create a legal barrier around these facilities, aiding them in avoiding law suits if they commit elder abuse or neglect towards their residents.

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