Nursing Home Abuse Lawyer Blog

Pamm Dickey, former Administrator of Pleasant Manor Nursing Home in Sapulpa, Oklahoma, reportedly is a family's worst nightmare - abusive to the helpless nursing home residents entrusted into her care.

The State of Oklahoma began watching the facility in the summer of 2008 after four complaints were filed concerning Dickey's behavior. In the August 15, 2008, 151 page report, Dickey is repeatedly cited for being both verbally and mentally abusive to residents and staff members.

A SAD SITUATION

A resident was admitted in May 2008 for rehabilitation following surgery on both knees, for which she had physician's orders for physical therapy. This resident required a mechnical lift to use the restroom and a wheelchair to move about. The resident needed to visit her orthopedist 32 miles away but Pleasant Manor's van couldn't make the trip. A lift van company could not be utilized due to the resident's knee braces and the family could not take her by car. Staff members advised Dickey of the situation; Dickey told the staff member to call the family to come and get her that she wanted the resident "out by Thursday (June 26). I don't care where she goes."

The resident's family could not transport her by car nor could they remove her from the facility as they could not carry her to the restroom. A staff member began the transfer process to another facility, but the facility social worker advised that she could not be taken until Friday, June 27. When Dickey was apprised of the situation, she replied, "yes, they will, they will accept her on Thursday because she'll be off skilled and I want her out of my building by 5 p.m. I don't care where she goes but she is not going to stay here. Hell, her daughter can keep her."

On June 27, the Administrator of the receiving facility called and set up a July 1, 2008 transfer date with the Director of Nursing via ambulance transport. On June 30, the Administrator contacted Pleasant Manor to confirm the transfer and was told that she needed to speak to Dickey. According to the Administrator of the receiving facility, Dickey began "yelling at me that she was going to kick [the resident] out on her a-- by 5 p.m. today!" When Dickey was questioned, she confirmed that she was the Administrator. The receiving Administrator was told that Dickey's "facility was being run by the state anyway and they appointed her to that position 'so they can kiss my ass!" The receiving Administrator told Dickey that it was unethical and asked her where were her morals. She stated that she was going to contact Adult Protective Services (APS) for the resident's safety and Dickey told her to "tell APS to bring a car to pick [the resident] up then because I will set her ass on the goddamn curb!"

OTHER ABUSIVE BEHAVIORS

The report noted that Dickey also argued with a resident over a television remote control and berated two residents for pushing their call buttons too often. She also removed a resident's belongings from her room and moved a roommate in with her while the resident was away having cataract surgery. She kept the resident's belongings, a Bible and magnifying glass among other things, locked up and refused to return them.

END RESULT

Pleasant Manor was slapped with a $10,000 per day fine from August 13 to 15, 2008 for subjecting residents to immediate jeopardy. The home is currently being fined $1,200 per day until it achieves compliance with federal and state regulations. Effective October 14, 2008, Medicare and Medicaid are denying payment for all new residents admitted until compliance is achieved. The home's provider agreement will be terminated on February 15, 2009 if it does not attain substantial compliance with regulations.

Dickey is to appear before the Oklahoma State Board of Examiners for Nursing Home Administrators concerning her license. Six complaints have been lodged against Dickey since 1999, when she was licensed, but she was cleared in those cases. She resigned as the Administrator of Pleasant Manor on August 13, 2008.

Northridge Nursing Home in North Ridgeville, Ohio, which is operated by Altercare, Inc., is finger-pointing in the blame game for poor survey results received recently.

Altercare, Inc. filed a lawsuit in Lorain County Common Pleas Court against former Chief Operating Officer, Lisa Marie Clark. The suit alleges breach of contract and seeks undisclosed damages and punitive damages of $500,000. The suit alleges that Clark mismanaged the facility, resulting in negative findings against the facility by government inspectors. Other allegations made in the suit were:

- Clark terminated the facility's relationship with a physician and his wound care practice, resulting in an "immediate jeopardy" citation;

- The activities staff was not certified, resulting in a regulation violation; and

- Therapy services were discontinued for most residents, often in violation of the resident's care plan; there were only 26 restorative therapy programs in March 2008 and now there are 98 restorative programs.

Clark was terminated on March 26, 2008, although Altercare, Inc. continued to pay her salary until June 22, 2008. Interestingly, an April 2008 survey indicated that there were two instances of "real and present danger" violations, in the 43 health code regulations included in the survey. The facility was cited for 34 health deficiencies and 10 fire safety deficiencies. A June 2008 survey revealed three instances of "actual harm and/or immediate jeopardy".

Christine M. Borasky was sentenced to 90 days electronic home monitoring and five years probation for her role in injuring an elderly woman in her care as a Certified Nurse's Aide at United Helpers Nursing Home in Ogdensburg, New York in August 2007. She pled guilty in September 2008 to the felony of second-degree endangering the welfare of a vulnerable elderly person.

On August 6, 2007, while caring for Grace Bradley, an eighty-two year old resident, Borasky was accused of pulling Ms. Bradley's hair and spraying foam into her mouth. Borasky also fractured Ms. Bradley's right hand while squeezing it on August 17, 2007.

Borasky was originally charged with two counts each of endangering the welfare of an incompetent or physically disabled person and willful violation of health laws and a single count of second degree endangering the welfare of a vulnerable elderly person. Judge Jerome Richards noted that Borasky's anger issues weren't compatible with elderly nursing home patients requiring specialized care and patience. He told Borasky, "You were in the wrong business from the start."

Borasky has surrendered her state license.

We discussed Glenwood Resource Center and its high death rate in our July 14, 2008 blog. At that time, Glenwood had repeatedly failed to improve medical care for its residents and was being investigated for an "unusually high number of deaths among its residents". The facility had been under a federal court order for the last four years to improve resident care and the home had made little or no progress to improve the medical care it provided to its residents. The Department of Justice has accused the State of Iowa of repeatedly failing to act on "significant concerns" raised by inspectors concerning medical care oversight at Glenwood. Inspectors have faulted the home for its inadequate investigations into resident deaths.

On March 9, 2008, a Glenwood resident died due to inadequate nursing care. Eleven days later, a 52 year old male resident died unexpectedly; the man had lived at the home for just eleven hours. He had been transferred to Glenwood from another county run home. During his autopsy, a disposable latex glove, 40 inches of cord, a tangled ball of string, and a tag from a bed sheet at the previous group home were all removed from his colon. In September 2008, Glenwood was fined $5,500 for alleged medication errors, among other problems.

Now, officials are investigating another death at Glenwood. A fifty-five year old female resident, who had resided at the facility for forty years, died. No details of her death are being released at this time. Since March 2008, nine residents of the home have died - three of which have occurred in six weeks.

Summit Park Nursing Care Center was fined more than $17,000 in the death of a 90 year-old Catholic nun. The nun, 90, was the third patient in less than a year to be injured at Summit Park Nursing Care Center due to an unsecured closet. On August 31, 2008, the nun was found in her room "conscious but bleeding profusely from her forehead, face, and left eye" after an unbolted closet had fallen on her head. The wardrobe was still on top of her. The nun, who suffered from dementia and heart disease, was taken to Good Samaritan Hospital and then transferred to Westchester Medical Center, where she died.

Tragically, state investigators uncovered two previous incidents where unsecured clothing closets had falled on patients at the Summit Park facility and went unreported to the state. One of those incidents had occurred just three weeks prior to the August 31, 2008 incident.

The facility faces additional state penalties due to the incident.

Glenwood Gardens, located in Bakersfield, California, has been hit with the worst fine possible - $100,000 - for the death of a resident. The 84 year old man, who suffered from dementia and breathing difficulties, died after choking on a ketchup packet. Staff at the facility was aware that the resident consistently tried to eat non-edible objects and failed to formulate a care plan to prevent ingestion of non-edible objects. A mortuary embalmer discovered the ketchup packet wedged in the back of the man's throat.

Glenwood Gardens Executive Director Dave Goodin advised that the facility is appealing the file stating, "There was no grounds we could find for the citation so we've appealed".

Southtown Nursing and Ventilator Care, located in Bixby, Oklahoma, was been cited for thirty-six violations of state and federal nursing home regulations. While violations were found during an annual inspection, the facility also has two pending complaints. Of the 102 beds available, the facility currently has forty-two residents.

Maintaining resident dignity appears to be a problem at Southtown. A quadriplegic resident, paralyzed as a result of a spinal cord injury, was found completely unkept in his wheelchair on August 26, 2008. His facial hair was long and matted with white flakes in his beard, the skin on his heel was thick with large patches of white loose skin, and his toenails were broken off, jagged, and dirty. His fingernails were dirty as well and a thumbnail was at least a half-inch long. He told the inspectors "my thumb nail needs to be cut. No one here has done any nail care for me. My dad tries to keep my nails done. I was clean shaven when I was admitted. They have attempted to shave me twice." He had been a resident at the facility for two and a half months.

The inspectors saw this resident again the following day. This time, he was wearing disposable incontinent pad as a brief. Inspectors questioned him about his "brief" and he replied, "Yes, they're doing everything as cheap as they can on me." On the next day, the man was in his bed without a brief or a pad and his buttocks showing. He stated, "I don't have a brief on. My butt's showing." He could not reposition himself or pull up his sheet due to his paralysis.

Another resident was found with a dried bowel movement on their gown and thigh. There was a strong ammonia smell noted and the underside of the resident's incontinent pad was soaked through. The aide cleaned the resident, changed her, raised her bed, and turned the tube feeding back on without ever changing her gloves or washing her hands.

The facility had a strong urine, feces, and body odor throughout the building and the odor remained for the five day inspection. In addition to the citation for failure to maintain resident dignity, the facility was cited for failure to establish and maintain an infection control program, failure to maintain a medication error rate of 5% or lower, failure to provide timely urinary incontinence care and that would prevent infection, failure to maintain a clean and sanitary environment, failure to implement doctor's orders to prevent bed sores, failure to implement policies that would prohibit resident abuse, neglect, and mistreatment, and failure to meet residents' nutritional needs and implement interventions to prevent weight loss.

A plan of correction was submitted by the facility and that plan was rejected on October 14, 2008. Interestingly, the facility owner, Scott Pilgrim purchased the facility after coming to the facility one day to visit his grandmother. He was angry over the way it was being run, so he purchased it. He has owned the facility for approximately fifteen months and feels it is vastly improved from the way it was. He minimized the citations by saying "one tag is too many, but the surveyors could write over 210 violations and we only had 36".

Mark Albright, a former employee of Chesapeake Health and Rehabilitation Center in Chesapeake, Virginia, was recently indicted on a charge of aggravated sexual battery of a 43 year old comatose patient at the facility. A police affidavit states that a female employee entered the patient's room to perform nightly medical duties when she observed the suspect with his mouth on the woman's breast. The patient had been a resident at the facility for approximately one year.

We have previously discussed New York's use of hidden cameras to reveal abuse and neglect in some New York care facilities. Now, New York Attorney General Andrew Cuomo is taking "granny cams" to the Buffalo area to help crack down on abuse and neglect at Buffalo nursing facilities. Cuomo's office was the first to use video camera surveillance at trial, which led to the conviction of several nurse aides and an owner of a nursing home on charges of nursing home abuse and neglect.

The cameras, used only with family permission, have revealed horrific abuse in the past, such as:

- failing to hydrate an immobile patient and leaving him in his own waste for nearly a day;
- failing to turn and position an immobile patient, leaving the resident at risk for bedsores;
- failing to shower a resident twice a week as required; surveillance tapes revealed that the resident had not been showered for over a week;
- failing to perform range of motion exercises, leaving the resident at risk of muscle contraction;
- leaving a comatose patient in waste for hours, while suffering from skin lesions, and not receiving proper care for his feeding tube; tragically, there were over forty occasions when the resident was not washed after an incontinent episode;
- caregivers sleeping, watching movies, or leaving the facility during shifts;
- falsifying records to conceal neglect; and
- only using one caregiver to transfer a bed-ridden patient to and from a wheelchair with a Hoyer lift that required the use of two caregivers, striking the resident's head on a side rail.

Cuomo used surveillance tapes from Medford Multicare Center and arrested four employees for dangerous neglect and further arrests are anticipated due to the ongoing investigation. To date, surveillance tapes have led to the convictions of 26 employees of various facilities.

Alexander Hughes, a private caregiver as well as activities assistant at Encore Senior Living Village in Gresham, Oregon, faces a 49 count criminal indictment, which includes aggravated identity theft, first-degree criminal mistreatment, and fraudulent use of a credit card after being accused of using the ATM card of the disabled woman for whom he cared. Hughes is accused of withdrawing over $600 from the account of the brain injured woman during a two day drug binge.

On September 28, he left the woman's home, telling her he was going to pick up medications at Walgreens. The woman never received her medication. Between September 30 and October 1, there were twelve withdrawals totaling $666. Hughes told investigators he was buying and smoking crack during the two day binge.

He has pled not guilty to the charges.

On July 11, 2008, Carol Crow was found with two black eyes and covered with bruises on her face, neck, and shoulders. The facility workers told Mrs. Crow's family that she had gone into her room and fell, but Mrs. Crow told her family an entirely different story. Mrs. Crow alleges that a man knocked her down, got on top of her, and beat her until she was unconscious. While Mrs. Crow does have early onset Alzheimer's disease, she was very clear about what happened to her.

Jack Crow, Carol's husband, is working with a group known as A Perfect Cause to change nursing home abuse reporting procedures. He is supported in his efforts by both the Oklahoma attorney general and the Oklahoma County district attorney's office.

Current Oklahoma statutes call for someone who suspects abuse or neglect is occurring at a state facility to report it to the Department of Human Services or the Sheriff's Department. Both the district attorney and the attorney general's office believe that the police should be called first. "When you have a crime scene, there is evidence," said Scott Rowland of the Oklahoma County district attorney's office.

To read more on this, go to Supporters Want Suspected Cases Reported to Police First.

The day began as planned - two teams of poll workers were sent to the Gardens of Western Reserve nursing home in Cuyahoga Falls, Ohio to assist elderly residents in voting. Early voting for nursing home residents is common as the residents would not be able to get out to vote otherwise.

The problem began around noon. Seventy-five year old Republican George Manos and seventy-three year old Democrat Edith Walker were assisting another resident with her ballot. The voting resident wanted to vote for John McCain, but her ballot was marked for Barack Obama. Somewhere along the way, events spun out of control.

Manos accused Walker of ballot tampering and says that he tried to get the ballot out of Walker's hand, but she refused to show him the ballot. Walker says that Manos accused her of marking the ballot incorrectly and that Manos was mean to her. The altercation escalated when Walker jumped onto Manos' back and struck him in the head three to four times. It took two other election workers to pull Walker off of Manos' back. Manos wants to prosecute.

The ballot was indeed marked incorrectly. AFter the tussel ended, the ballot was actually marked for both candidates. The voting resident was provided with another ballot and was finally able to vote for her chosen candidate.

Marlene Z. Robertson, current owner of Cloverleaf Healthcare Center in Hemet, California, faces trial on November 6, 2008 on charges of attempted bribery. She was charged in 2006 by the California State Attorney General.

Robertson and her corporate administrator, Isidra Agulto, were arrested and charged with five counts of bribery and one count of conspiracy to commit bribery. Robertson's boyfriend, Josemar Mercado, was arrested and charged with one count of conspiracy to commit bribery. At the time of her arrest, Robertson owned six nursing homes, including Huntington Healthcare Center in Los Angeles, Casa Maria Healthcare Center in Fontana, and Cloverleaf Healthcare Center in Hemet. She offered money and gifts to inspectors in exchange for information concerning upcoming inspections and investigations of her facilities.

In September 2005, Robertson's Huntington Healthcare Center was cited with 40 health and safety violations. Residents were wearing soiled clothes, animal droppings were found near food in the dining area, and a patient was seen with an open head wound.

In February 2006, problems were so bad at Robertson's Casa Maria Healthcare Center that the Public Health Department appointed a temporary manager to run the facility after an inspection revealed nearly 50 health and safety problems. The facility was closed three months later.

Recently, the owners of Hemet Valley Healthcare Center in Hemet have decided to close that facility. There are eight facilities in close proximity where the residents of that facility could transfer. The problem? One of those facilities is Robertson's Cloverleaf Healthcare Center in Hemet. Pat McGinnis, the executive director of California Advocates for Nursing Home Reform, has repeatedly complained to the California State Public Health Department about Robertson and her operation of nursing homes and says that "there are absolutely no consequences for abuse of residents. Patients had better be very, very careful".

We have been following the investigation into the suspicious death of Elmore Kittower while a resident at Silverado Senior Living in our previous blog entries. Elmore Kittower died from a blood clot in his lung, but an autopsy report also indicated that "blunt force trauma" factored into his death. His body was covered in bruises and he had unexplained partially healed rib fractures. Nursing home employee Cesar Ulloa was arrested after an extensive investigation into the death of Mr. Kittower. Authorities exhumed Mr. Kittower's body after a whistleblower told authorities that Mr. Kittower was beaten mere minutes before his death.

The investigation has now expanded to include the alleged abuse of three more helpless residents at the facility. A seventy-eight year old woman was violently awakened when an employee began "jumping on her chest". When the resident tried to protect herself, the employee "picked her up WWF style and slammed her onto the bed". The elderly woman, who suffers from a brain condition that left her unable to speak, became withdrawn and didn't want people touching her, even family members. Her son said, "She started to act like a wounded animal. But when she finally found out who you were, she didn't want to let you go."

Ulloa is also accused of abusing two other vulnerable nursing home residents with dementia and early stage Alzheimer's.

Authorities are still searching for the whistleblower in this tragic situation. Ulloa has pled not guilty to four counts of elder abuse and one count of torture.

The Centers of Medicare and Medicaid recently determined that Nodaway Nursing Home in Maryville, Missouri can no longer be allowed to bill either of the health insurance providers. Why? The facility has failed to correct a state and federal deficiency since April 2008, six months after its initial discovery. The consequence? Residents admitted to the facility after October 28, 2008 will not be covered through Medicare or Medicaid. Those admitted on or before the deadline date of October 28, 2008 will have until November 28, 2008 to find a new place to live.

Interestingly, the citations are for the facility's failure to follow proper protocol in documenting and monitoring patients. There have been two follow up inspections and similar deficiencies were found both times. Employees did not keep appropriate records concerning a resident receiving medication, charts were improperly signed or not signed by the correct person, and in one instance, the patient never received medication ordered for constipation.

The nursing home has explained their shortcomings as "just a glitch", but Medicare and Medicaid officials have not given inspectors permission to return to the facility for a fourth inspection. Without the inspection, there would be no opportunity to clear up the deficiency and no opportunity to bill Medicare or Medicaid for the residents.

To read more about this matter, go to Inspection Woes for Area Nursing Home.

We previously discussed the tragic death of 50 year old Sarah Comer at Metron's Big Rapids, Michigan facility. In January 2005, Ms. Comer died after Metron employees failed to give her the oxygen she needed to live. Eight employees conspired to cover up the circumstances which lead to her death. Those former employees now face criminal charges in Ms. Comer's death.

Attorney General Mike Cox is expected to announce that the independent monitor, that had been appointed to settle the lawsuit that was filed due to Ms. Comer's death, will continue supervision because Metron's standard of care has not substantially improved.

The monitor can inspect any Metron homes without warning and can assess penalities for failing to abide by state standards. Metron has homes in Belding, Big Rapids, Cedar Springs, Forest Hills, Greenville, and Lamont. Since 2005, when the monitor was appointed, Metron has been fined over $300,000. Moreover, the Attorney General and Department of Community Health for the State of Michigan have forced the sale or closed three facilities in Kalamazoo, Bloomingdale, and most, recently, last month in Allegan. At the Allegan facility, in 2007, a resident died when employees failed to provide oxygen that was needed. Recently, Metron's Big Rapids facility has been labeled a "special focus facility" by the Department of Health and Human Services due to serious quality of care problems and failure to improve care.

To read more on this subject, go to State Attorney General's Office Says Monitoring of Metron Nursing Homes Still Necessary.

Often when a loved one needs to go into a nursing home, it is a last minute decision. Usually, there is an event, such as a fall or a hospitalization, that triggers the need for "expert" care. How do you choose the safest place for your loved one on short notice?

1. Seek out experts, such as social workers, doctors, or nurses, to discuss their recommendations and experiences. You may also want to consult friends or other family members with loved ones currently in nursing homes to see if that facility might be a good fit for your family member.

2. You can contact Eldercare Locator at (800) 677-1116. Eldercare Locator can connect you with the appropriate agency which will have a listing of nursing homes in your area. There are also Ombudsmen that can be contacted for specific questions about facilities you are interested in.

3. Once you have reached a decision on a facility, call and ask for a tour of the facility. Be sure and check the cleanliness of the kitchen and restrooms. You should ask to see the inside of the refrigerator. Is the refrigerator clean? Is food covered and look appetizing? Is the restroom clean? Does it have hot water? Where are the residents? Are they left alone in their rooms or are they in common areas? Are staff paying attention to them? Is there some kind of group program or activity going on to help keep them stimulated? Are restraints being used on patients?

4. Go online to www.Medicare.gov and pull up the inspection reports for the facility you are interested in. Do they have any deficiencies? If so, what type? Was anyone's life put in jeopardy? As the Administrator about what you reviewed. Is the Administrator up front and honest about the inspection reports or cagey?

5. Once your loved one becomes a resident at the facility, plan frequent visits at a variety of times. Random vists will encourage the staff to care for your loved one in the best possible way as they will never know when you will be arriving and you will get to know the facility staff and the methods of operation so you can watch what is going on. Plan on attending family care meetings and do not be afraid to express your ideas about what needs to be improved.

Roy Reed Shelton was sentenced to one to five years in prison for sexually assaulting a 57 year old female resident of the Dora Allietta Memorial Home in Moundsville, West Virginia last year. He pled guilty to third-degree sexual assault, second-degree sexual abuse, and indecent exposure. Sheldon said the sexual relationship was consensual, but authorities contend that the woman has the mental capacity of a two year old.

Shelton lived at the facility with his wife, who worked there, but the facility has since been shut down after authorities determined that the residents were not properly cared for.

Two licensed practical nurses and two certified nurse aides were caught on surveillance tapes over a six week period seriously neglecting a disabled resident, who required assistance with all activities of daily living. Over a six week period, surveillance tapes at Medford Multicare Center for Living in Suffolk, New York revealed that staff failed to move and turn the patient for hours at a time, failed to provide water for the resident whose only source of hydration was through his gastrostomy tube, and left him sitting in his own waste for almost a day.

Facility staff also failed to perform range of motion exercises to prevent muscle contractions, failed to provide a shower for more than one week, and failed to use the appropriate number of aides to transfer the resident using a Hoyer Lift. In fact, one aide was seen using her cell phone while transferring the patient without assistance and on another occasion, this aide struck the resident's head on the side rail of the bed while performing a transfer.

Rima Chaudhry, Toni Miller, Betty Cheslak, and Jacqueline Francis are all accused of falsifying business records and endangering the welfare of a physically disabled person. The investigation at the facility continues and more arrests are anticipated.

Governor Schwarzenegger's recent state budget cut state funding for local ombudsman programs in California. These local nursing home ombudsman programs investigate complaints at nursing facilities. The local budget for California ombudsman is approximately $200,000; Governor Schwarzenegger's recent budget cut $35,000 from that budget, or 1.25 positions out of 3.7 positions. The loss will make it increasingly difficult for the ombudsman program to respond to complaints at nursing facilities and to provide desperately needed training for facilities on abuse prevention. Kathleen Johnson of Advocacy, Inc., which operates ombudsman programs in two California counties, is concerned that the $35,000 cut will trigger an additional $15,000 loss of matching federal funds. This would be a combined budget loss of $50,000, or one-fourth of their operating budget. Ms. Johnson stated that all nursing homes in the counties she deals with have deficiencies that need to be addressed. These cuts will likely create worse conditions.

Cincinnati's Health Department revoked the operating license of the Terrace, a long term care facility owned and operated by Abe Fischer. If you will recall, the state shut down the sister facility, Westside Healthcare Center, after a raid on the facility found its residents living in filthy, unsafe conditions. The facilities owned by Fischer were described by police as "worse than any crack house" they had seen. The facilities were dirty and feces and vomit were found on the floors. Doors were tied shut and electrical wires were exposed.

Westside Healthcare Center recently closed.

Abe Fischer had hoped to combine the two facilities into one new long term care facility.

We previously discussed the suspected torture and abuse that occurred at a Calabasas nursing facility in our blog. Cesar Ulloa is accused of being the ringleader of a group of four employees who punched and tortured select residents. Ulloa is accused of repeatedly assaulting Elmore Kittower up to minutes before his death.

Cesar Ulloa pled not guilty on Monday, October 6, 2008 to a torture charge and several counts of abuse against four residents residing at Silverado Senior Living. His bail is set at $1.2 million. If convicted, Ulloa could face life in prison.

The California Department of Public Health issued a "AA" citation, the state's most severe citation, and fined Hemet Valley Healthcare Center $100,000 after a resident taking two blood thinners died after suffering a blow to the head. Olga Baroncini, 81, died on September 16, 2007 at Loma Linda University Medical Center. She was sent to Hemet Valley Healthcare Center to recover from colitis, deep venous thrombosis, and pulmonary embolus.

Ms. Baroncini suffered a head injury on September 14 during physical therapy. There remains some confusion over whether she struck her head on the back of a chair or on a bedrail while being assisted by a physical therapist. The physical therapist did not report the injury because he did not think it was serious. The nurse on duty did not check Ms. Baroncini for changes in her condition nor did she report the head injury to the doctor, in violation of facility policies and procedures. Why? Because she didn't think it was "anything big". The nurse has since been fired.

Ms. Baroncini's blood pressure dropped and she lost consciousness the next day. She was taken to the hospital and transferred to another hospital where she was removed from life support and died. Her death may have been preventable had her physician been notified. If the nurse had reported the injury to a doctor, Ms. Baroncini could have been removed from the blood thinners she was taking and tests could have been performed sooner. Facility officials did not report Ms. Baroncini's death to the state, even though they were aware of it.

A twelve year-old foster child was severely burned at the Florida Club Care Center, a skilled nursing facility located in North Miami-Dade, Florida. The child, who suffers from Cerebral Palsy so severe that investigators "think she's incapable of acting out to provoke harsh discipline", is unable to communicate and is completely reliant on facility staff for all activities of daily living, including eating, dressing, and bathroom use. The second-degree burns she sustained were on her left hand and thigh. No explanation was provided by the facility. There have been eight reports of abuse or neglect involving children at the facility in the past.

The Child Protection Team, which is a group of University of Miami doctors and nurses determining child mistreatment, determined that this child was a victim of a victim of abuse. A scathing letter from pediatrician Michael D. Strong, a pediatrician and a member of the Child Protection Team, to Governor Charlie Crist, stated that Dr. Strong was "shocked" at the apparent lack of due diligence when investigating the matter on the part of the Agency for Health Care Administration, whose report found no evidence that the child had been burned. The Department of Children and Families has determined that their caseworkers will increase their visits to the home until the abuse concerns can been corrected. Additionally, there will be a "monitor" placed at the children's nursing station from 8:00 a.m. to 10:00 p.m. in an effort to address the problems.

Timothy Patrick White, 46, has been charged with fifteen counts of rape and related charges in the sexual assault of a dying 70 year-old nursing home resident suffering from Alzheimer's disease and a brain tumor. Reportedly, White took the victim, who has less than six months to live, from the Manor Care Nursing Home in Philadelphia, Pennsylvania on July 22, 2008 and took her to a bar for rum and cokes and then to Cobbs Creek Park, where they drank beer until 5:30 a.m. When he returned the victim to the nursing home, nursing home staff noticed that the victim was not wearing any underwear and had bruises on her mouth, neck, and arms. White was not wearing a shirt and his pants were unbuttoned. He told facility staff that he was "a friend of hers" and drove away. The victim had no idea of what had happened due to her decreased mental capacity and was unable to give consent. At this point, it remains unclear as to how White was able to remove the victim from the facility. Nevertheless, DNA samples taken from White match DNA recovered from the victim.

We discussed a class-action lawsuit that had been filed aginst Extendicare, one of the largest nursing home chains in North America, in our previous blog. The suit, which was originally filed in King County Superior Court in the State of Washington, has since been moved to U.S. District Court in Seattle, Washington and has been expanded to include allegations that Extendicare homes admitted residents without regard to their healthcare needs in order to increase profits. The suit alleges that Extendicare violated consumer protection laws by advertising high quality, skilled nursing care and not providing same. Extendicare is also accused of violating a state law barring nursing homes from forcing residents to sign a form waiving liability for injury or property loss.

Abe Fischer, former owner of Westside Health Care Center and current owner of the Terrace at Westside, has signed a plea agreement that his company will pay $5,000 for code violations found at his properties in a police raid on March 13, 2008. The charges against Abe Fischer personally were dropped. Fischer faced jail and up to $6,000 in fines if convicted.

We have discussed this situation previously in numerous blogs. The facilities owned by Fischer were described by police as "worse than any crack house" they had seen. The facilities were dirty and feces and vomit were found on the floors. Doors were tied shut and electrical wires were exposed.

Westside Health Care Center has since been closed and the city health department will determine next week if the Terrace at Westside will be allowed to remain open.

An eleven month investigation following eighty year-old Elmore Kittower's death resulted in four arrests on Thursday, October 2, 2008. Mr. Kittower, a former engineer, lived at Silverado Senior Living, an upscale Calabasas, California assisted living facility that specializes in care for Alzheimer's and memory-impaired patients. He had suffered a severe stroke, causing him to lose much of his memory and independence. His widow, Rita Kittower, was told that her husband of 49 years had died in his sleep. The day after his burial, a woman known as "Maria" called her and told her that a fellow Silverado employee had punched Mr. Kittower in the eye and wrapped a towel around his head as if attempting to suffocate him, shorly before he died. The same woman made calls anonymously to the Lost Hills sheriff's station and sent a letter to a fire station making the same allegations.

The ensuing investigation resulted in interviews with nearly eighty employees and the exhumation of Mr. Kittower's body in November 2007. The arrests Thursday were the culmination of the eleven month investigation which revealed that Cesar Ulloa, a twenty year-old employee of the facility, was the ringleader of a group of four employees who regularly harassed and abused Mr. Kittower and several other facility residents. Los Angeles County Sheriff's Department homicide detectives allege that they have evidence that Ulloa physically assaulted Mr. Kittower mere minutes prior to his death and had been torturing him for months. The coroner indicated that Mr. Kittower died from a lung blood clot but also found evidence of blunt force trauma. Others arrested were Luis Arrelleando, 21, Juan Soto, 21, and Maria Gomez, 34.

Mrs. Kittower paid $75,000 annually for her husband's care. In return, the facility has stonewalled attempts by the family to learn more about how Mr. Kittower died. In fact, the facility has even sent two questionnaires to Mrs. Kittower asking how Mr. Kittower had enjoyed his stay at the facility. The family is offering a $10,000 reward for more information concerning the treatment Mr. Kittower received at the facility.

We discussed the Westside Health Care Center in Cincinnati, Ohio in a previous blog and the failure of the Cincinnati Health Department to identify serious and potentially life-threatening conditions at the facility. A March 2008 police and state regulator raid involving Westside Health Care Center and its companion facility the Terrace at Westside exposed leaking sewage, soiled mattresses, vomit on floors, broken toilets, exposed wires, improperly trained employees, and many other serious violations.

The City of Cincinnati is the only city in Ohio that performs its own nursing home inspections. At least, it did until October 1, 2008, when the City Council voted 7-2 to turn over the annual health and safety inspections to the Ohio Department of Health.

Westside Health Care Center and the Terrace at Westside are both owned by Abe Fischer. Westside Health Care Center was recently closed.

Sandra Kegler, a care giver at Parson's House assisted living center in North Austin, Texas, has been charged with injury to an elderly individual. Ms. Kegler was seen on surveillance tapes attempting to use credit cards that residents at Parson's House had reported missing. An employee background check was performed on Ms. Kegler, which revealed no criminal history. An arrest warrant has been issued.

Robert Gundersen, a nursing home aide employed by Northeast Nursing Staff Service, L.L.C. of Glenmont, was assigned to work at the Eddy Ford Nursing Home in Cohoes, New York in August and September 2008. On September 2, 2008, Gundersen forcibly kissed the wheelchair-bound resident suffering from Multiple Sclerosis and put his tongue in her mouth. Due to her condition, she was unable to push him away from her. Gundersen was arrested and charged with first degree sexual abuse and forcible touching. He faces up to seven years in prison and would have to register as a sex offender.