California law defines a nursing home, or skilled nursing facility, as a facility that provides 24-hour skilled nursing care, related services, or rehabilitative services for the injured, disabled, or sick individuals. The typical resident is a person who is chronically ill or recuperating from an illness and needs regular nursing care and other health related services. Residents in skilled nursing facilities are supervised by their personal care physician or the facilities medical director. Each resident must have an individual plan of care developed by the physician, resident and facility staff. These facilities provide a protective environment with medical and social services for individuals whose needs cannot be met in a less restrictive setting.  All nursing homes in California must be licensed with the California Department of Public Health and meet nursing home standards set by the state.  The nursing homes that participate in Medicare and Medi-Cal programs have to be certified by the federal government to qualify for federal payments.  Federally certified facilities must meet federal and state requirements.

Wrongful death claims are in the news stemming from elder abuse.

Skilled nursing facilities all over the San Diego area have been riddled with news of abuse, wrongful death, negligence, injuries to patients and even sexual assaults.  Elder abuse is increasing in San Diego even as the area is touted as a safe and beautiful place to live.  Caretakers or children are often the abusers initiating activities that involved physical assaults and financial crimes.  The State of California has fined and given citations to certain facilities that have caused wrongful deaths and injuries due to neglect and abuse.  Elder abuse as it pertains to nursing homes is the failure to prepare and follow an updated care plan unique to each resident, a failure to provide water and food, failure to provide care for activities of daily living, and failure to treat an elder person with dignity and respect.  Violations of these abuses happen every day and knowing what they look like can spare a family from a wrongful death incident down the road.

What do signs of abuse look like?

Bodily Injury – Physical abuse may reveal itself through: 1) unexplained bruises or injuries, or recurrence of the same type of injury, or abrasions; 2) signs of restraint on wrists and ankles such as bruising, cuts or abrasions, using restraints for long periods of time can cause patients to suffer from lower muscle tone, reduced bone mass, and muscle disorders; 3) malnutrition, dehydration and sudden or severe weight loss; and 4) when staff will not leave family alone with resident for fear they may tell of abuse.

Neglect – Physical neglect is a type of abuse that may or may not be intentional, perhaps as a result of not enough staff or supplies at a nursing home.  Resident’s cleanliness, availability of food, clothing and surrounding sanitary environment that diminish human dignity are signs to look for and overlap with physical abuse of malnutrition and dehydration.

Verbal or Emotional Abuse can present itself in many different ways such as agitation, nervousness, fear, or sadness. Acts of emotional abuse can be intentional, but they can also be unintentional when the abuser is overly stressed and unknowingly lashing out or harming the elderly person. Emotional abuse can be both verbal and nonverbal in nature.  Verbal abuse is characterized by verbal harassment, yelling, or emotional manipulation that the abuser inflicts on the elderly. In nursing homes, abusive caregivers must be reported immediately. Non-verbal abuse can make elderly patients feel isolated, helpless, and afraid. After witnessing this abuse once, you may not notice that abuse is occurring, but the repetitive nature of this type of abuse can cause serious psychological and emotional damage to a nursing home resident. Nonverbal forms of abuse include: 1) silent treatment; 2) threatening to cause physical harm; 3) ignoring resident and keeping them from socializing; 4) restricting food, water and using the bathroom; 5) treating them as if they were children; and 6) hiding or taking away personal items.

Exploitation Abuse occurs when someone improperly or illegally uses or steals a resident’s funds, assets, or property.

Sexual Abuse could reveal itself through 1) a new case of sexually transmitted diseases (STDs); 2) difficulty walking, sitting or complaints of pelvic injury; 3) bruises, irritation, bleeding or pain on inner thighs and genital areas; 4) bloody, torn or stained clothing items; 5) agitation and withdrawal from socializing; 6) PTSD symptoms and panic attacks; 7) unusual sexual or inappropriate behaviors toward abuse suspect; and 8) attempts at suicide. The largest percentage of elder sexual abuse, around 70.7% of cases, occurred within nursing homes.

What is wrongful death in a nursing home?

 A wrongful death civil lawsuit action is filed against someone who improperly caused the death of another.  In a nursing home neglect situation, the family or loved ones of the deceased would be filing the suit which needs to answer four substantial questions: 1) was death caused by nursing home and/or employees; 2) was conduct of workers, caregivers, medical or facility personnel a contributing factor to the death; 3) is the person filing the lawsuit legally attached to the deceased as in spouse, children, family members; and 4) did the death of the nursing home resident cause damages and pain and suffering? Basically, if a wrongful death has occurred while under the supervision of the professionals who were supposed to care for the person, the family may be entitled to compensation for their damages. Wrongful death in a nursing home can be caused by many things including negligence and abuse, and that is why it is imperative to recognize the signs of abuse and negligence before they progress to death.

Who is responsible for negligence and abuse causing personal injury or wrongful death?

 The nursing home facility can be held liable for any wrongful death, personal injury or neglect causing harm or death to a resident in their care.  This negligence may have occurred on their part through 1) negligent hiring, 2) understaffing, 3) breach of regulatory obligations to guidelines maintaining safety and licensure, 4) insufficient employee training, or 5) errors in treatment or medication dispensing.  Liability is the state of being responsible for something, especially by law, vicariously liability is a legal doctrine assigning liability for the injury to a person even if they did not cause the injury directly but had a legal relationship with the negligent person who caused the injury.  This means that a nursing home employer can be held responsible for the negligent or abusive acts of its employees during the course of their work and through the scope of their job descriptions. Due to the nature and varying levels of care given at nursing homes, there are often contracted workers who have direct access to residents that may cause purposeful harm or harm through negligence to a resident.  Those parties, through their contracts with the nursing home, may share the liability for any neglect, abuse or injury to a resident.

Contact legal counsel.

Nursing home abuse victims have rights. If you put your spouse, grandparent or other loved one in a nursing home, you have a reasonable expectation that the facility will provide a certain level of attention and care. If you think your loved one is being mistreated in a nursing facility, you may pursue compensation for their pain and suffering through a personal injury lawsuit. Nursing home and elder abuse is a serious matter under United States law, and it is a criminal act. Depending on your situation, and the nursing home abuse case, you could be entitled to compensation for medical costs and pain and suffering. With the assistance of a personal injury attorney Jeffrey E. Estes & Associates, you may consider filing a lawsuit for your loved one.

Jeffrey E. Estes & Associates

501 West Broadway, Suite 1650

San Diego, CA 92101