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.

Update on Investigation of Elder Abuse at Calabasas Nursing Home

Investigation of Death Led to Allegations of Senior Abuse

In a prior blog entry, we followed the investigation into the death of Elmore Kittower, an 80 year-old resident of Silverado Senior Living in Calabasas. Kittower’s widow, Rita, was told by a woman claiming to be a nursing home employee that her husband had been beaten and suffocated by another employee at the nursing home. This led to an investigation by the Los Angeles County Sheriff’s Department and resulted in a finding that the trauma to the body was consistent with an assault.

The Los Angeles Times reported this week that the investigation of Silverado has been expanded to include the examination of the possible abuse of three other elderly residents of the nursing home. Cesar Ulloa, a former Silverado caregiver, is alleged to have abused the three other residents. Ulloa has been charged with four counts of elder abuse and one count of torture. Ulloa entered a not guilty plea, when he was arraigned in Los Angeles Superior Court.

An autopsy performed on Kittower, the resident whose death sparked the investigation, revealed that he died due to lung blood clot. However, the report also indicated that “blunt force trauma” played a role in his death. Moreover, Kittower’s body had multiple bruises and evidence of a recently partially healed rib fracture.

Another resident of Silverado that was allegedly harmed was the mother of Keith Stubbs. Stubbs was told by authorities that his mother was awakened and forced out of bed by having her chest jumped on. Stubbs’ mother had a brain condition that prevented her from being able to speak, preventing her from reporting any possible abuse.

Ulloa’s other alleged victims are two other Silverado residents, Richard McDonough and Robert Turner. Turner’s nephew, Richard Skowronek, indicates that he was told by authorities that, at the very least, his uncle was punched in his stomach.

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

Stubbs indicated that he did not suspect that his mother had been abused. However, in retrospect Stubbs noted he started seeing bruises on his mother’s arms and neck even prior to Ulloa beginning work at the nursing home, and that more recently he noticed that his mother recoiled when visiting loved ones touched her, which she had not done previously.

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

Families of nursing home residents must be vigilant in their observations to protect their loved ones from possible abuse. The California Attorney General’s Crime and Violence Prevention Center suggests that you look for the following possible indicators of abuse:

Physical indicators

• Unexplained bruises or welts
• Poor skin condition or poor skin hygiene
• Untreated medical condition
• Cuts, pinch marks, skin tears, lacerations or puncture wounds
• Bruises or welts in various stages of healing
  

Behavior Indicators

• Confusion, withdrawal, fear, or anger

Social Indicators

• Interaction or activity within the family is restricted or prohibited
  
• Not given the opportunity to speak for him/herself or see others without the care-giver present

Financial Indicators

• Lack of amenities - TV, personal grooming items, appropriate clothing
  

For further information on the warning signs of elder abuse, visit the California Attorney General’s Crime and Violence Prevention Center at www.safestate.org.

Thanks for reading my blog. If you suspect that a loved one has been a victim of nursing home abuse or neglect, contact me for immediate assistance.