Nursing Home Fined $80,000 in Patient’s Death

Homewood Care Center in San Jose was fined $80,000 and given a “AA citation”, the most severe penalty under California law, after a state investigation determined that a nurse’s failure to administer the Heimlich maneuver on a choking patient resulted in the patient’s death. According to a report by the Department of Health and Human Services, the patient was admitted to the care facility with a diagnosis of Alzheimer’s disease and dysphagia, or difficulty swallowing. The man was assessed as a high risk for aspiration (the entry of secretions into the trachea and lungs) due to difficulty of swallowing. The report also indicated that the man had a no-CPR order, meaning he did not want any cardiopulmonary resuscitation, however investigators concluded that a no-CPR order does not preclude abdominal thrusts, such as those performed during the Heimlich maneuver.

Patient Choked While Being Fed Dinner
On August 24, 2009, at 5:30 p.m., a certified nurse assistant was feeding the man a dinner of pureed food when he suddenly began coughing violently. Although staff members thought the man was choking on food, they did not attempt to perform abdominal thrusts to clear his airway. Investigators found the facility did not promptly call 911. Although staff members claimed they called 911 at 5:30 p.m., records indicated the call was placed at 5:49 p.m., a delay of 19 minutes. A police report indicated the man was dead when paramedics arrived.

Aftermath of this Tragedy
Following the death of the patient, a registered nurse who failed to implement emergency procedures was fired, and the director of nursing at the time of the incident was relieved of his duties.

When the state health department issues a citation or finds a deficiency, the care center must submit a plan of correction. After the plan is accepted and the health department completes a surprise inspection, the agency issues a fine or citation. Homewood submitted a plan of correction, which was accepted on March 11, 2010.

Nursing Home Owner’s Troubled History
Until January of this year, Homewood was owned by Jack Easterday, who is currently in prison for withholding $9.6 million in payroll taxes from employees’ checks and willfully failing to pay employment taxes. Easterday was the sole shareholder of Westline Medical Management, which owns Homewood and seven other nursing homes in California. Easterday resigned as a corporate officer of Westline in January and transferred his shares to an administrator. Easterday and Westline have a history of providing poor nursing home care. In 2007, two other facilities owned by Westline were each fined $100,000, the highest fine possible, for their role in the death of two patients.

If you or someone you know has been the victim of nursing home abuse or negligence, contact the Casiano Law Firm for a confidential consultation to discuss your case.

San Diego County Nursing Home Fined for Resident's Death

Fallbrook Hospital District Skilled Nursing Facility, located in San Diego County, has received the most severe penalty under California law that long-term nursing facilities can receive. An investigation by the California Department of Public Health (CDPH) revealed that inadequate care had led to the death of a male nursing home resident last summer.

Fallbrook received an "AA" citation and was fined $90,000 by the CDPH. The CDPH is responsible for issuing citations and fines when nursing homes are found to be providing inadequate or negligent care of their residents. The CDPH has three different categories for citations and fines, with the "AA" citation being the harshest penalty. The categories are as follows:

- Class AA: $25,000 to $100,000 fine

- Class A: $2,000 to $20,000 fine

- Class B: $100 to $1,000 fine

According to CDPH's site, an "AA" citation is defined as "a violation that has been 'determined to have been a direct proximate cause of death of a patient or resident of a long term care facility.'" To enforce an AA citation, the CDPH must prove (1) the violation was a direct proximate cause of death and (2) the death resulted from an occurrence that the regulation was designed to prevent.

According to California Healthcare Foundation's (CHF) site, Fallbrook is located in Fallbrook city in San Diego County. The facility accepts Medicare and Medi-Cal and it has a total of 93 beds. On CHF's site, Fallbrook received a below average rating for the number of hours staff devote to each resident per day. The facility also received a below average rating for the "complaints" category, and as for the "quality of care" category, CHF noted that eight percent of Fallbrook residents spend most of their time in bed, whereas the State's average was five percent.

In this particular instance, the director of CDPH, Mark Horton, stated that Fallbrook failed to initiate a plan to prevent the resident's risk of injury. The male resident was listed as having a high risk of falling. When the resident did fall, he broke his leg and he subsequently died of complications resulting from the surgery to his leg.

Federal Nursing Home Laws

Nursing homes that participate in Medicare and Medicaid programs must comply with federal rules regarding the type of care residents should receive. Under Title 42 CFR Section 483.20, nursing homes must conduct initial and periodic assessments of each resident's functional capacity. The assessment must include a review of the resident's cognitive patterns, communication, psychosocial well-being, physical functioning, and medications among other factors.

Title 42 CFR Section 483.25 also states that each resident must receive and the nursing facility must provide "the highest practicable physical, mental, and psycho-social well-being" for residents, in accordance with the assessment of the patient's needs and plan of care. It appears that in this situation, Fallbrook failed to take the necessary measures to ensure that the resident would be safe and not susceptible to injury.

When nursing home management and staff fail to abide by federal and state rules, the risk of serious injuries and deaths of nursing home residents are considerable. It is imperative that families, who are trying to find the right nursing facility for their loved ones, research and visit facilities before making their final decision.

Unfortunately though, incidents of nursing home abuse and neglect do occur. If you or someone you know has been the victim of nursing home abuse or negligence, contact the Casiano Law Firm for a confidential consultation to discuss your case.