Jonathan Rosenfeld's Nursing Homes Abuse Blog : Jonathan Rosenfeld's Nursing Homes Abuse Blog | Lawyer & Attorney : Strellis & Field Law Firm | Bed Sores, Senior Neglect, Elder Abuse, Sexual Abuse: Chicago, Illinois

Over the last 20 years, federal and state legislatures have drafted many laws with the intention of protecting the most vulnerable members of our society-- they elderly.  As the laws accumulate, it is important to know what laws apply to particular situations of abuse or mistreatment and how to properly apply them to particular situations.

What is elder abuse?

Elder abuse is the abuse, neglect, and financial exploitation of elderly persons. Older adults are particularly vulnerable to this type of abuse because of their isolation, illness, or fear. In the United States, an estimated 1 to 2 million Americans age 65 and older have suffered from abuse.

In Illinois, an estimated 76,000 persons over age 60 suffer from elder abuse, but only 10,000 elderly victims report this abuse to the Elder Abuse and Neglect Program each year. The 2008 Illinois Elder Abuse and Neglect Program Annual Report, Demographics reveals that of reported cases of abuse in Illinois in 2008: almost one in four victims are age 86 or older, the most common report received involved financial exploitation followed closely by emotional abuse, 77% of abusers were either the spouse, child, or other relative, and 70% of victims were female.

What is the Elder Abuse and Neglect Act?

The Elder Abuse and Neglect Act (320 ILCS 20/1 et seq.) is an Illinois law established to “design and manage a program of response and services for persons 60 years of age and older who have been, or area alleged to be, victims of abuse, neglect, financial exploitation, or self-neglect.” This program is administered by the Illinois Department on Aging and is coordinated locally through 45 provider agencies. The Program provides investigation, intervention, and follow-up services to victims of elder abuse.

The Elder Abuse and Neglect Program responds to the following types of abuse (320 ILCS 20/2(a)):
 

Physical abuse – inflicting physical pain or injury upon an older adult

Sexual abuse – touching, fondling, intercourse, or any other sexual activity with an older adult who is unable to understand, unwilling to consent, threatened, or physically forced

Emotional abuse – verbal assaults, treats of abuse, harassment, or intimidation

Confinement – restraining or isolating an older adult, other than for medical reasons

Passive neglect – caregiver’s failure to provide an older adult with life’s necessities (food, clothing, shelter, medical care)

Willful deprivation – willfully denying an older adult medication, medical care, shelter, food, therapeutic device, or other physical assistance which exposes that person to the risk of physical, mental, or emotional harm

Financial exploitation – misuse or withholding of an older adult’s resources by another, to the disadvantage of the elderly person, or the profit or advance of someone else

In order to encourage people to report elder abuse (call Elder Abuse Hotline at 1-866-800-1409), the Act provides that a person who reports suspected elder abuse in good faith or cooperates with an investigation will be granted immunity from criminal or civil liability or professional disciplinary action and their identify will not be disclosed without written permission or a court order. The Department on Aging, Office of Elder Rights started a campaign called Break the Silence (brochure) to increase public awareness of elder abuse.

Illinois law requires that persons delivering professional services to older adults (social services, adult care, law enforcement, education, medicine, state service to seniors, and social workers) report suspected abuse of older persons who are unable to report for themselves. This mandatory reporting requirement only applies if the reporter believes that the older person is not capable of reporting the abuse themselves. Any physician who willfully fails to report as required by the Act is referred to the Illinois State Medical Disciplinary Board. Any other mandated reporter required by the Act who willfully fails to report is guilty of a Class A misdemeanor.

The Department also encourages people to report suspected elder abuse even when not required. If the older person is a nursing home resident, reports are made to the Illinois Department of Public Health’s Nursing Home Hotline (1-800-252-4343).

Applicability of Elder Abuse & Neglect Laws to Nursing Homes and Group Homes

Nursing homes and group homes are intended to provide a safe and secure home for your family members when they are unable to live on their own or need special care and services. These facilities promise to take care of our loved ones with the care, respect, and safety that they deserve. However, many cases of elder abuse and neglect occur in these very facilities.

Illinois nursing homes are subject to federal and state laws including the Illinois Nursing Home Care Act (210 ILCS 45), which establishes minimum standards for the facility. The Illinois Department of Public Health (IDPH) is responsible for licensing nursing homes in order to ensure that they provide adequate and proper care for their residents. In addition, Illinois nursing home residents are guaranteed certain privileges according to the rights and protections afforded under State and Federal law (Resident’s Rights brochure).

When you enter a long-term care facility, you maintain the right to safety and good care, privacy, manage your own money, participate in your care, safety of your personal belongings, and keep living in your facility. It is important to remember that you do not lose your rights just because you enter a nursing home facility.

One of the most important rights you have is freedom from abuse, neglect, financial exploitation, and self-neglect. If a nursing home employee, medical worker, social services worker or other mandated reporter who is engaged in carrying out their professional duties suspects that a nursing home resident is being abused or neglected, they have the responsibility to report their suspicions to IDPH under the Elder Abuse and Neglect Act. Additionally, any person who suspects abuse or neglect may also voluntarily report their suspicions to IDPH.

IDPH is responsible for investigating allegations of abuse or neglect in long-term care facilities, including nursing home facilities. When a mandated reporter or any other person who suspects elder abuse reports an allegation to IDPH, an investigator responds to the complaint to ensure that the elderly person is not living in an abusive situation. An investigator will usually visit the facility in question and perform a face-to-face assessment with respect to a complaint report along with any casework and follow-up as required by Department protocols.

If you suspect that an older adult, age 60 or older, is being subjected to abuse, neglect, or exploitation, it is important to report your suspicions to the Illinois Department on Aging or the Illinois Department of Public Health if the person is a nursing home resident. Older adults, especially those with mental disabilities or illness, are particularly vulnerable to abuse and neglect. It is important to be vocal proponents of the safety and well-being of older adults to ensure that they receive adequate care and services while maintaining their rights.

Resources:

ILGA: Elder Abuse and Neglect Act
State of Illinois: Elder Abuse and Neglect Act and Related Laws
Illinois Department on Aging: Resident’s Rights Brochure
Senior Services Inc: Elder Abuse Intervention

Related Nursing Homes Abuse Blog Entries:

A Legal Victory For Nursing Home Residents. State Laws Can Supersede Federal Arbitration Act

Elder Abuse: Why Bruises Can Be Tell-Tale Signs Of Poor Care

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

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Indiana Police are currently investigating a suspected sexual assault of a 76-year-old patient at the Alpha Home Rehabilitation Center.  Police believe the elderly woman was assaulted in her room at the skilled nursing facility.  The incident remains under investigation by local police as they are unsure if the assault was perpetrated by an intruder or an employee at the facility. Currently, no suspects are in custody.

Related Nursing Homes Abuse Blog Entries:

Update On Nursing Home Rape: Facility Made Errors In Investigation Of Incident

Nurse Charged With Rape Of Disabled Patient

Nursing Home Fails To Report Suspected Sex Abuse To Authorities

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Perhaps there is no more visual reminder of abuse or mistreatment than a bruise.  The discoloration is not only ugly in appearance, but it can also be a source of pain for the individual.  Because bruising can be a relatively common occurrence in the elderly, I think its important to learn more about this medical condition and hopefully become better at identifying a bruise due to mistreatment vs. the normal aging process.

What is a bruise?

Bruises can result after an injury, a fall, or even bumping into something. A bruise (contusion) is an injury to the soft tissue that results in broken capillaries which leak red blood cells. As the heart pumps, the blood escapes to the surrounding tissues, creating a bruise. 

Bruises can surface hours or even days after an injury and can also show up on a different part of the body than was injured. Bruises are usually reddish in color at first, turning bluish-black or purple after a couple hours, then yellow, green, or brown as they heal. Because bruises involve skin trauma, they are usually painful for at least the first few couple days. 

How bruises heal.

Bruises fade gradually as your body reabsorbs the blood that leaked from your blood vessels. After an injury, you can take steps to prevent or minimize bruising. This includes applying a cold compress to the injured area, elevating the injured area, and avoiding blood thinning medications if possible. During the healing process, a bruise will fade in color, from bluish-black or purple to a yellowish green to a lighter brown before disappearing. This color change occurs as the body’s white blood cells remove the decayed blood products little by little. In most cases, bruises heal in one to two weeks, but deeper, more severe bruises can last longer. 

Bruising in the Elderly.

Older adults bruise more easily and heal more slowly than younger adults because they have fragile capillaries and thinner skin. This is because as you age, your skin becomes thinner and you lose some of the protective fatty layer that helps cushion your blood vessels. In addition, bruises in older adults can last longer than the usual 1-2 weeks, sometimes lasting for months. 

Certain drugs can also make you more susceptible to bruises, many of which are common medications for older adults. Many older adults take non-steroidal anti-inflammatory medication for arthritis including ibuprofen (Advil, Nuprin) and naproxen (Aleve), which can interfere with blood clotting. Blood-thinning medication such as aspirin, Coumadin (warfarin), and Plavix (clopidogrel) reduce your body’s ability to clot, which can cause increased bruising. In addition, corticosteroids can make your skin thinner, making you more susceptible to bruises. 

Signs of abuse?

Bruises are one of the most common indicators of nursing home abuse and neglect. This is important to note because elder abuse, including physical abuse, is on the rise. Elderly nursing home residents are vulnerable to injuries and abuse because of weakness, illness, and decreased mental cognition. 

Many times the elderly residents who are victims of abuse are unable to alert family or staff of the abuse. They might be too scared to report the abuse or too embarrassed, or even unable to remember the abuse that they were forced to endure because of a cognitive impairment. 

Residents with moderate or severe dementia may be unable to give an accurate description of abuse or neglect. Oftentimes, the context in which an injury occurs is just as important as the injury itself in screening for elder abuse and mistreatment. Because of the serious risks associated with elder abuse, nursing home staff must be properly trained to recognize signs of abuse and closely monitor residents for common signs of injury or abuse, such as bruising. 

In Illinois, if a nursing home suspects that a resident’s injury might have been caused by abuse, the facility must report the matter to the Illinois Department of Public Health, investigate the alleged abuse, and provide a copy of the investigation to the Department. (Illinois Administrative Code: Long-term care facilities – 77 Administrative Code 300.3240 Abuse and Neglect). Nursing home facilities must take all injuries seriously, especially bruises that might indicate abuse (because of bruise location, size, or re-occurrence). 

Oftentimes, it is difficult to determine if bruising is normal, accidental bruising or something worse. In order for facilities to better be able to recognize abuse, the literature must be improved by documenting normal bruising in the geriatric population. This could then provide a point of comparison for nursing home facilities and caregivers when they encounter suspicious bruises. Until then, nursing homes must err on the side of caution, investigating all injuries that seem even slightly suspicious in order to protect our elderly population. 

Although older adults bruise more easily, staff should still be concerned when residents have bruises, especially if they are in patterns or clusters, or the bruises reappear.  The pattern or shape of the bruise can sometimes provide clues as to the cause of an injury (bruises can occur in the shape of knuckles or fingers). Bruises in patterns can indicate the use of restraints (bruises on hips and arms can indicate the use of bed rails, and bruises on the wrists can indicate the use of cuffs). Frequent or serious falls are another common cause of bruising, and can indicate improper supervision of a resident. In order to provide the best possible care, nursing homes must have care plans in place to prevent residents from suffering from accidents and abuse. 

The location of the bruising may also indicate abuse. The most common locations for non-accidental injury are the face, neck, chest wall, abdomen, and the buttocks. A study in the Journal of American Geriatrics Society, Bruising as a Marker of Physical Elder Abuse, reported that bruises occurring as a result of physical elder mistreatment are often large (> 5 cm) and occur on the face, lateral right arm, and back of the torso. 

In another study published in the same Journal, The Life Cycle of Bruises in Older Adults, the study revealed that almost 90% of accidentally acquired bruises in adults aged 65 or older occur on the extremities. In a sample of one hundred adults aged 65 and older, there were no accidental bruises on the neck, ears, genitalia, buttocks, or soles of the feet. And, if the bruise was on the trunk (torso) of the body, the subjects were more likely to know the cause of the bruise. 

Therefore, nursing home staff should pay particular attention to bruises that occur on a resident’s face, arm, and back because these areas have been shown to have the greatest incidence of bruising in cases of mistreatment. 

If you notice bruising on a family member who lives in a nursing home, you should ask the staff members about the cause of the bruising. Elderly adults are vulnerable to abuse and neglect and every effort should be made to prevent or stop mistreatment. 

Resources:

Mayo Clinic: Easy Bruising, Common As You Age

Medicine Net: Bumps and Bruises

Kansas University Law School: Elder Abuse in Nursing Homes, Does Bruising Tell a Story?

Journal of the American Geriatrics Society: Bruising as a Forensic Marker of Physical Elder Abuse

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I was glad to see criminal charges have now been filed against Pamela Ott, the Administrator at Kern Valley Healthcare District, after several employees of the facility allegedly used psychotropic medications to control the behavior of patients with Alzheimer's and dementia.  Ott is now facing eight felony counts of elder abuse.

The instances of nursing home abuse allegedly occurred between August 2006 and January 2007 when the employees intentionally over-medicated residents with anti-psychotic drugs at Kern Valley Skilled Nursing Facility to keep them quiet and make them easier to handle. 

As the administrator of the Kern Valley Healthcare District, Ott was responsible for supervising the operation of a small community hospital and skilled nursing facility in Lake Isabella, CA.  

A Healthcare Ombudsman who witnessed a resident of Kern Valley being forcibly held down by nursing home staff and injected with drugs brought the situation to the attention of authorities. In total, 22 residents of the California nursing home were believed to be intentionally drugged by the threesome. Additionally, the deaths of three residents are also believed to be related to the improper drugging.

"As hospital administrator, Pamela Ott, was responsible for the safeguarding the welfare of her patients.  Instead, Ott abdicated her responsibility and allowed the staff of the Kern Valley Hospital to forcible sedate patients who questioned their care," said Attorney General, Edmund G. Brown Jr.

Among the three nursing home employees who have already been criminally charged:

• Gwen Hughes, 55, the former director of nursing
• Debbi Gayle Hayes, 51, the facilities former pharmacist
• Dr. Hoshang M. Pormir, 48, a staff physician at Kern Valley Healthcare District who was the medical director at the skilled nursing facility

In situations involving dangerous patient care, it is important that elevated officials at the facilities be held responsible.  I am glad to see that this Attorney General did a thorough investigation and is moving forward with criminal charges for Ms. Ott's supervisory role in this situation.  

Read more about this case involving over-medication in a California nursing home here.

Related Nursing Homes Abuse Blog Entry

Nursing Home Employees Plead 'Not Guilty' To Charges Related To The Intentional Chemical-Sedation Of 22 Elderly Residents

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Today marks the fourth annual World Elder Abuse Awareness Day sponsored by the International Network for the Prevention of Elder Abuse (INPEA).  WEAAD seeks to promote awareness of elder abuse and neglect in all settings around the world by bringing together governmental and civic organizations.

INPEA is an organization, founded in 1997, which is dedicated to the global dissemination of information as part of its commitment to the world-wide prevention of the abuse of older people.

Learn more about how you can get involved in preventing elder abuse here.

Know The Signs of Elder Abuse:

• Unexplained bruises, cuts, burns, sprains, or fractures
• Frozen joints
• Unexplained venereal disease or genital infections, vaginal or anal bleeding
• Bloody clothing
• Sudden changes in behavior
• Staff refusing to allow visitors to see resident or delays in allowing visitors to see resident
• Resident being kept in an over-medicated state
• Sudden loss of an appetite

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Seemingly straight out of the fiction section, another CNA stands accused of punching an elderly person she was responsible for caring for. The Champaign County Sheriff arrested Sharoia D. Hill of Danville, IL, for the aggravated battery of a senior citizen. 

The alleged battery took place at the Champaign County Nursing Home in Southern Illinois, where Hill was a CNA in the Alzheimer's unit.  According to Hill's co-workers, the elderly man involved would not return a gait belt, used to help transfer residents, back to Hill.  In apparent retaliation, Hill punched the man two times with a closed fist.  A co-worker witnessed the abuse and immediately alerted authorities.

Hill has been working at the Champaign County Nursing Home since March 17th.  If convicted of the felony charges, Hill faces two to five years in prison and fines up to $25,000.

Is the facility responsible for the actions of the CNA?

If the facility had knowledge of the CNA's violent tendencies or the facility failed to do a proper background check prior to hiring they may be held responsible for this incident.  If however, the facility had no prior knowledge of this CNA's violent propensities, it is unlikely that they have an legal responsibility in a civil lawsuit. 

Web Resources

Police: Nursing Home Worker Punches Patient, Illinoishomepage.net

Nursing home employee accused of hitting resident, The News-Gazette.com

The National Center For Victims of Crime: Elder Abuse

Nursing Homes Abuse Blog Posts Related To Champaign County Nursing Home

Medicare Fraud Unit To Investigate Illinois Nursing Home

Most Nursing Home Deaths Remain Uninvestigated

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The pending criminal trial of Jill and Julie Barry will have an important impact on Illinois seniors as it will help define what constitutes 'reasonable care' when it comes to the home-care of elders. Currently, prosecutors in Illinois have few parameters when it comes to the definition of 'elder abuse' because Illinois courts have not formally ruled on the issue before. Consequently, the decision as to how to define 'reasonable care' in a criminal neglect context will fall squarely on jurors.

In 2008, Kane County State's Attorney, John Barsanti filed criminal neglect charges against the Barry sisters related to their responsibility to provide care to their elderly mother. Kane County jurors will soon make a determination if the care the sisters provided was 'reasonable'-- or criminal- for their 84-year-old mother.

The criminal charges follow a 2007 Kane County Coroner-ordered investigation.  The coroner ruled Mary Virgina Barry's death was a homicide due to the physical sings of neglect encountered during an autopsy. 

An investigation revealed that prior to her death, Ms. Barry weighed just 70 pounds, had extensive bed sores, and had not seen a doctor for nine months. According to a paramedic report, Ms. Barry was lying in soiled bed sheets and had ants crawling on her when authorities were called to her home.  Barry was immediately taken to a local hospital where she died several days later.

Web Resource:

Elder abuse: Trial to shed light on horrors in home and help home Illinois law, chicagotribune.com, April 2, 2009

Nursing Homes Abuse Blog Related Entries

Southern Illinois Nursing Home Sued For Resident's Decubitus Ulcers

Grim Details Emerge Regarding Malnutrition In Kentucky Nursing Home

Judge Tosses Manslaughter Charges Against Nursing Home Employees In Case Involving Death Of Disabled Resident

Criminal Charges May Be Brought Against Chicago-Area Nursing Home In Connection To Resident's Death

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Though commonly used, 'elder abuse' really means a variety of harm to an older person.  The Administration on Aging defines elder abuse as "the intentional or negligent act by a family member or caregiver that causes harm or serious risk of harm to an older adult."

Elder abuse encompasses:

• Physical abuse is inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
• Sexual abuse is the infliction of non-consensual sexual contact of any kind.
• Emotional or psychological abuse is the infliction of mental or emotional anguish or distress on an elder person through verbal or nonverbal acts.
• Financial or material exploitation is the illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
• Neglect is the refusal or failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
• Self-neglect is characterized as the behavior of an elderly person that threatens his/her own health or safety.
• Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

Source:

Department of Health & Human Services, Administration on Aging

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After ignoring two bench warrants and months on the run, Pennsylvania authorities have captured Henrietta Sprual, an self-admitted elder abuser.  Sprual pleaded guilty to multiple charges of elder abuse including: simple assault, recklessly endangering another person, possession of and instrument of crime and making false statements to authorities in connection to an incident where she beat an Alzheimer's patient she was responsible for caring for at the Arden Court assisted living facility.

An investigation into the incident revealed Sprual struck the elderly man six to eight times with a belt. Prosecutors have photographs of the man's bruises on his arms, elbow, shoulder, knee and thigh.  The bruises were so severe, an imprint of the buckle could be seen.

Sprual's confession comes after she told authorities the man found the belt in the nurses station and was 'out of control' swinging the belt around and striking himself.  A forensic pathologist advised authorities that the man's injuries were not self-inflicted and it was obvious force was used to inflict them.

"I'll know where you are now," Montgomery County President Judge Richard J. Hodgson told Sprual as he revoked her bail and ordered her held in jail until the sentencing hearing.  Sprual faces a possible sentence of three to seven years in prison.  

Photographing Nursing Home Injuries

This case highlights the importance of taking photographs as soon as feasible of both the injured person as well as any injury causing instrumentality.  Many times nursing home residents are physically unable to describe a situation involving nursing home abuse or nursing home neglect. Photographing the injury provides valuable evidence for both criminal and civil cases.

Related Articles

Convicted Elder Abuser Captured By Authorities, The Times Herald, February 4, 2009

Woman Accused Of Beating Elderly Man Skips Court ... Again, The Reporter, February 1, 2009

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Authorities are looking for Jacqueline Anne Lumpkin, a certified nursing assistant at an Alabama Nursing Home, who is accused of stealing an elderly resident's identity to fraudulently buy goods and services valued at more than $5,000.  Warrants for Lumpkin's arrest were issued on December 4, 2008 and she is being charged with: elder abuse / neglect, financial exploitation, identity theft and fraudulent use of a credit card.  Each count caries a $15,000 bond.  Authorities are still attempting to learn if there are more residents that Ms. Lumpkin has taken advantage of.  Read more about this case of financial exploitation of the elderly here.

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Three new laws have recently taken effect in California to help protect seniors from physical abuse, neglect and financial exploitation. 

• SB 1140- Attempts to define elder abuse more clearly and provides stiffer penalties.  Taking advantage of a person's weakness of mind, lack of confidence or physical frailty - known as 'undue influence'  - is now grounds for criminal action.  The law requires immediate return of the senior's property if taken under undue influence.
• SB 1136- Provides punitive penalties to those who con senior into paying for free services such as Medi-Cal or Medicare coverage.
• AB 2100- Require state ombudsmen, those who police nursing homes and assisted living facilities, to report suspected abuse to the District Attorneys Office.

'I think we are only seeing the tip of the iceberg right now," said Mike Gargiulo, head of the Los Angeles County District Attorney's Elder Abuse Division.  "Our business  is going to expand exponentially with the aging population."

According to the U.S. Census, the number of people over 65 is expected to grow from the present figure of 39 million to 62 million by 2025.  Currently, the American Psychological Association estimates that 2.1 million seniors suffer from elder abuse, but only a small percentage of the cases get reported to officials.  Read more about new laws to protect the elderly here.

If you are the victim of abuse or suspect abuse of a loved one, the National Center For Prevention Of Elder Abuse has a useful website that provide information on reporting abuse for each state.

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I just got an email from Wes Bledsoe, founder of A Perfect Cause, regarding the Minnesota State's Attorney's indecisiveness in bringing felony charges against the young women who allegedly abused Alzheimer's patients at the Good Samaritan Society - Albert Lea Nursing Home.

Here is a copy of the email.  I encourage everyone to forward this email, as this really is an issue that deserves to be in the headlines.

Here’s your call to action!

Please call Craig Nelson… the Freeborn County Attorney in Albert Lea, MN… as soon as possible today. Please send this appeal to ALL on your email lists… plus ask family, friends, associates, and co-workers to call.

Nelson’s office number is 507.377.5192.

You can even fax him at 507.377.5196. I do not have his email address but anyone who does have it, please send it to me and I will circulate that too.

We invited Nelson to attend the town hall meeting last night. He declined, saying he’d “wait to see what happened in the media and hear from the court of public opinion.”

So… here’s your chance to be the “court of public opinion.”

What do we want?

1.       Felony Charges filed against the alleged assailants

2.       If convicted, the assailants should be required to register as sex offenders

3.       If he chooses not to file felony charges, he should immediately recuse himself and turn the case over to the MN Attorney General’s Office due to a conflict of interest

Why?

 1.       The families of the Good Samaritan Society – Albert Lea (nursing home) victims and many citizens of Albert Lea have asked us for our help.

2.       Nelson has

a.       Charged the alleged assailants of these victims with only class five misdemeanors

b.      Stated the assailants will "most likely will face suspended jail sentences and probation, so they'd have the threat of jail hanging over them if they get in more trouble”

c.       A conflict of interest due to a reported relationship with at least one of the alleged assailant’s families (he therefore should recuse himself and his office from the case)

3.       The alleged assailants are smarter than the County Attorney, as reported the alleged         assailants targeted victims who could not tell on them and if they did, that no one would       believe them

a.       Nelson’s office states the victims are not reliable witnesses

4.       Failure to prosecute physical and sexual battery committed against vulnerable adults by caregivers sends a loud and clear message that it is open season on any long-term care             residents in the future

5.       The alleged criminal acts committed against these elderly and vulnerable adults should be considered as “Hate Crimes”

Background on the case

Larson – Complaint - http://stmedia.startribune.com/documents/2albertlea.pdf?elr=KArks:DCiUHc3E7_V_nDaycUiacyKUU

Broitzman – Complaint - http://stmedia.startribune.com/documents/1albertlea.pdf?elr=KArks:DCiUHc3E7_V_nDaycUiacyKUU

Minnesota Department of Health – Investigative Report - http://www.health.state.mn.us/divs/fpc/directory/surveyapp/ohfcfindings/h5441019.pdf

More to Come

Yes, I am upset about the State of Minnesota and CMS’ policy to cite ZERO deficiencies if facilities “self-report” and “offer an acceptable plan of correction.” These agencies will be our next target, but I want to give them an opportunity to talk and modify this policy before we move on them.

Yesterday was an incredible experience. We met with two families… had seven television interviews throughout the day… two print media interviews… met with an ally who is funneling information to us… plus the town hall meeting.

Here’s what the media had to say about…

Last Night’s TOWN HALL MEETING

Star Tribune

Families sound off on abuse at Albert Lea nursing home

http://www.startribune.com/local/36022444.html?elr=KArksUUUU

Albert Lea Tribune

http://www.albertleatribune.com/news/2008/dec/12/residents-respond-alleged-abuse-case/

Advocate stirs debate on elder case

KIMT

Good Samaritan Abuse Charges Get National Attention

http://www.kimt.com/news/local/36024879.html

FOX 9

Town Hall Meeting Addresses Albert Lea Nursing Home Abuse

http://www.myfoxtwincities.com/myfox/pages/News/Detail?contentId=8054920&version=4&locale=EN-US&layoutCode=TSTY&pageId=3.2.1

KXMC

Minn. nursing home hit hard by abuse allegations

http://www.kxmc.com/News/308028.asp

WCCO

Nursing Home Hit Hard By Abuse Allegations

http://wcco.com/health/nursing.home.abuse.2.885548.html

KSTP

Minn. nursing home hit hard by abuse allegations

http://kstp.com/article/stories/S702828.shtml?cat=1

KAAL

Family Members Speak Out on Nursing Home Abuse

http://kaaltv.com/article/stories/S702744.shtml?cat=10151

KTTC

Family member appalled over nursing home charges

http://www.kttc.com/global/story.asp?s=9508954

KARE 11

Albert Lea community speaks out about nursing home allegations

http://www.kare11.com/news/news_article.aspx?storyid=531759&catid=14

Yes… we can… and together… we are… making a difference!

Many thanks for all!

Wes

Wes Bledsoe

Citizens’ Advocate & Founder

A Perfect Cause

1501 N. Broadway Blvd., Bldg B

Oklahoma City, OK 73103

C – 405.308.3858

C – 405.802.2903

Wes@APerfectCause.org

www.APerfectCause.org

Our Mission - To End Needless Suffering & Preventable Deaths

 "A Perfect Cause must produce a perfect effect."

Science of Mind, Dr. Ernest Holmes

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Three employees of Gowanda Nursing Home, of New York, face criminal charges related to their allegedly abusive treatment of their elderly patients.  According to court papers, Andrew Austin, a CNA at the New York Nursing Home, admittedly used racial epithets and physically attacked a resident after he refused to take his medications. The abusive behavior lead to convictions of endangering the welfare of an incompetent or physically disabled person and willful violations of state health laws.

In a separate incident, Jeffery Perry, a nurse at Gowanda, allegedly tied an elderly resident with dementia to a chair for two consecutive nights.  Perry faces charges of endangering the welfare of an incompetent or physically disabled person. The third Gowanda nurse charged, Jeanette Sovereign, was charged with endangering the welfare of an incompetent or physically disabled person and willful violation of health laws for not reporting nurse Perry's abusive behavior to proper authorities.  Both Perry and Sovereign pleaded not guilty during their recent arraignments.  Read more about the criminal charges brought against these nursing home workers here.

These are just the most criminal charges brought against New York nursing home employees by New York Attorney General Andrew Cuomo.  Cuomo's investigation of nursing home abuse and neglect has resulted in:

• Sentencing of the nursing home company, Highgate LTC Management, to pay $15,000 in fines, be barred from the business for a period of time, and accept responsibility for patient neglect that occurred at its Cortland facility, which was uncovered with the use of hidden-cameras.
• Sentencing of a former aide at the Rome Memorial Hospital Residential Health Care Facility to 25 years in prison for raping and sexually assaulting a 90-year-old resident of the nursing home.
• Arrest of a certified nurse aide who stomped on an 84 year-old female resident of Kaleida Health Deaconess Skilled Nursing Facility in Buffalo while the resident was lying in the fetal position.
• Arrests of two Rome nursing home employees for stealing and then pawning an engagement ring belonging to an 89-year-old resident.
• Arrest of a certified nurse aide for sexually abusing a physically disabled patient at the Eddy Ford Nursing Home in Cohoes.
• Sentencing of a certified nurse aide who stole $8,000 from a 97-year-old resident at The Waters of Orchard Park nursing home in Orchard Park in order to pay a debt she owed for the purchase of cocaine.
• Arrest of a former Gates nursing home employee who allegedly stole and forged personal checks from a resident, and then deposited them in her own bank account.
• Sentencing of certified nurse aide formerly employed at the Blossom North Nursing Home in Rochester for using two elderly residents' Social Security Numbers to fraudulently obtain cable service from Time Warner Cable and power from Rochester Gas & Electric.

To date, Attorney General Cuomo's ongoing nursing home investigations, including the use of hidden-cameras, have led to the arrests or convictions of more than 47 nursing home employees.

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Episania Fitzgerald was charged with abuse and neglect of an elderly person when she decided to leave her post as night nurse at an assisted living facility.  Fitzgerald told the sheriff's office investigating the matter that she left the assisted living facility with another resident in charge to provide home health care services elsewhere. 

Fitzgerald was gone for more than two hours, leaving the 21 elderly residents completely unattended.  During, nurse Fitzgerald's leave an 88-year-old resident fell on the bathroom floor requiring paramedic assistance.  It is unknown what, if any action the facility will take as discipline for this nurses inexcusable behavior.

This incident demonstrates the importance of selecting a well staffed facility.  It is important for families to specifically ask how many nurses, physicians, and CNA's are on duty throughout each shift.  While state and federal laws set staffing minimums, it is generally not a good idea for any one person to be solely responsible for the care of a large number of residents.  

Read more about this situation involving nursing neglect here.

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The Los Angeles Times recently reported on a story involving potential abuse of an Alzheimer's patient at an assisted living facility in California.  Four employees of the Calabasas assisted-living facility were recently arrested on suspicion of elder abuse stemming from the death of a resident last year.  Elder abuse charges follow on a report from an anonymous whistle blower who was an employee at the facility.  The whistle blower told the victim's family that a co-worker had punched the resident in his eye and attempted to suffocate the man shortly before his death.  The allegations have been confirmed by the sheriff's department who have an employee of the facility in custody.

Anytime there are multiple employees involved in a crime or pattern of abuse, others are aware of the behavior.  In this case another employee tipped the family and authorities to the abuse.  How long did this employee know the abusive behavior was going on?   How many other employees were aware of this?  Could this incident have been prevented?

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This article in the New Press, a fort Myers, Florida, newspaper caught my attention.  The article by Janine Zeitlin, uses statistics to prove what many close to to the elderly already know- elder abuse and elder neglect is a dirty little secret.  Most cases of elder abuse and elder neglect go unreported. When cases are discovered they are difficult to prove.

According to the article, the Florida Department of Children and Families found that adults make up about 18 percent of their abuse cases.  The real extent of abused senior abuse may never be known. Unlike minors where the state may forcefully intervene in a potentially abusive situations, if elders refuse to get help there is little authorities can do.

Another complicating factor in learning the full extent to elder abuse is that many elderly don’t go to the doctors that often, and that might be the only time they’re out of their homes. Elders in nursing homes and long-term care facilities are similarly isolated from the general population.  Rarely do nursing home residents venture into the community.  

Even with obstacles in place authorities do what they can to discover situations involving elder abuse and neglect.   The Department of Children and Families discovered a case of nursing home abuse and neglect involving a 90-year-old woman at Johnson Hall Home.  Although the woman had a large infected sacral wound that had evolved, the facility did not provide her medical attention. The department also used its investigative resources to discover a case of neglect which lead to death involving a 95-year-old nursing home resident.

The above situations demonstrate the need to report nursing home abuse and neglect.  If you suspect the mistreatment of a nursing home resident, you can contact your local department of public health and make a report.  In most situations, the report may be done anonymously.

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For most clients and their families the topic of abuse occurring in a nursing home is filled with anger, shame and frequently embarrassment.  Clients' ask;  "Why did this happen to my mother?"  "What could I have done to prevent this."  "Can I report this abuse anonymously?" 

While certainly not reassuring, the reality is that situations involving verbal, physical and sexual abuse in nursing homes are a common occurrence.  If people learned of the frequency of these occurrences, they would would be shocked and outraged.   The more people who step forward and report this incidents, the more action state and federal agencies may take to prevent future occurrences.

The nursing home industry has done a good job keeping the extent of these occurrences under wraps. Most situations involving elder abuse go unreported due to the inability of some people to communicate and misunderstanding about where and how to register a complaint.  In most states, the department of public health is responsible for fielding and investigating complaints related to nursing home abuse and neglect.  Further, anyone may initiate the complaint and it may be done anonymously if you wish.  In, Illinois, you may contact the Illinois Department of Public Health to make a complaint here.

I came across some startling statistics regarding elder abuse on the Center for Justice & Democracy's website.  Here are some of the low-lights:

Most nursing home abuse goes unreported

• 1 to 2 million Americans over 65 have been injured or exploited by a person responsible for their care.
• 1 in 6 cases of elder abuse, neglect or exploitation gets reported.
• In 2000, there were 472,813 reported incidences of abuse.  This means that there were 2,364,065 incidences of unreported abuse!
• There are 1.9 million adverse drug event occurring each year in long-term care facilities.  70% are preventable.  Up to 86,000 adverse drug event (medication errors, overdoses) result in death or severe injury.

A small number of nursing homes are responsible for the majority of the abuse

• 20% of nursing homes were cited for safety violations, many resulting in serious injury or death between July of 2000 and January, 2002.
• In a study of California nursing homes: 23% of the facilities were responsible for 71% of the lawsuits involving abuse or negligent care, 10% of the nursing homes were responsible for half of the lawsuits filed against nursing homes.

Nursing home owners are making hefty profits.  Desire for profits frequently results in cutting corners with respect to patient safety.

• For-profit nursing homes (which make up the vast majority of facilities) have profit margins of 20% to 30%.
• For-profit nursing homes have 32% fewer nurses and 47% more deficiencies that non-profit facilities.
• Many extremely profitable nursing homes have set up 'shell companies' that protect owners and investors from regulators and litigation.  In some cases, severely injured residents are unable be fairly compensated because they can not access the full resources of the company.

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Think the term 'nursing home abuse' is made up by lawyers?  Cameras don't lie...

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40-year-old, Roberto Cruz Recendes, was extradited to the United States and placed under arrest for the 2002 beating and rape of a 94-year-old woman in a Palo Alto assisted living center, according to Palo Alto Police.  The arrest stems from a May 10, 2002 incident at an assisted living facility.   Police responded after a resident reported she had been beaten and raped by an intruder, agent Dan Ryan said.  Recendes lived near the facility at the time of the incident and since relocated to Mexico.

Currently, Recendes is charged with one count of sexual assault during the commission of a burglary and one count of elder abuse with great bodily injury, according to Ryan. He is being held in the Santa Clara County main jail without bail.  Read more about this case of elder abuse here.

It is great that law enforcement officials were able to work together to track down this guy.  The question remains: Was this incident preventable in the first place?  The answer most likely is a resounding 'yes.'  Nursing homes and assisted living facilities have a duty to provide safe environments for their residents.  This includes screening all people who enter the facility, securing all windows and doors and most importantly--carefully monitoring the residents.

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If you suspect an elderly friend or relative is the victim of abuse or neglect, it is important to report the episode to authorities.  Making reports to the proper agency does three important things: 

1. Alerts authorities to current situation and allows them to get your loved one to safety.
2. Creates a records of the incident with authorities regarding the nursing home, hospital or long-term care facility.
3. Allows authorities to correct abusive and dangerous situations to prevent similar situations from happening to others.

The National Center on Elder Abuse has created a centralized database for reporting elder abuse in every state.  The site has links for: nursing home abuse hotlines, licensure and certification agencies, fact sheets on nursing home reform and listing of state ombudsman.  Help create safer environments for our elderly and report incidents of abuse and neglect today.

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A nurse's aide responsible for the home care of a 61-year-old Bensenville woman, was sentenced to 3 1/2 years in prison for stealing.  The nurse's aide stole at least $7,000 from the Chicago-area woman who suffered from disability related to polio and was dependent on a respirator to breath.  According to the victim, her home care provider studied her sleep patterns and noise levels to steal from her when she was in a deep sleep.

Read more about this incident here.

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Financial deceit is the most common form of elder abuse.  An Alabama nursing home employee took advantage of her position as an accounts payable clerk to write checks against nursing home residents' patient trust fund.  Anne Marie Jones, plead guilty to two counts of first-degree theft and one count of second degree criminal possession of a forged instrument.  Over a two year period Ms. Jones stole $97,036 from residents' accounts at South Haven Manor Nursing Home.

Read the full article about financial fraud here.

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