Nursing Home Abuse Lawyer Blog

Randall Moons died from a heart problem in December 2009 after being involved in an altercation with a roommate at Fox River Pavilion. The roommate said he called for help for "over 20 minutes" before another resident summoned a staff member. The roommate suffered a broken kneecap and bleeding from his nose, ears, and mouth from the brawl.

A forty-eight year old mentally disabled resident was allowed to eat inedible objects, such as napkins, toilet paper, and latex gloves. The resident had to undergo surgery to remove the foreign objects.

A suicidal twenty-five year old resident was allowed access to a razor blade with which she cut her arm, requiring 40 stitches.

We discussed Fox River Pavilion and its problems in previous blogs. Now, Illinois regulators have undertaken the necessary steps to revoke the license of this nursing home. Nearly 100 residents have been moved into other facilities within the past month. The facility lost its Medicare funding after the facility was cited for reportedly failing to provide sufficient supervision for the residents residing there. The facility was fined $30,000 for multiple violations.

A for-profit facility owned by David Meisels, Fox River Pavilion is the second Illinois facility to face state action. In March 2010, Somerset Place in Chicago surrendered its license.

Raquel Bravo

Thirty-five year old Raquel Bravo, a CNA at First Coast Health and Rehabilitation Center in Florida, faces up to five years in prison and a $5,000 fine if convicted of abusing a disabled adult. Reportedly, Bravo was seen hitting a disabled adult three times. She is currently suspended from her position pending the outcome of an investigation into the allegations by the Medicaid Fraud Control Unit.

Resident Oliver Shrock died after falling at the former Kindred Healthcare Center of Orange in July 2009. His family is seeking justice for his death.

Oliver Shrock moved into the Kindred facility on May 10, 2009 for rehabilitation. Among his ailments, he suffered from coronary artery disease, hypertension, diabetes mellitus, and congestive heart failure. He needed assistance with dressing, eating, washing, and using restroom facilities.

After a fall, Shrock was assigned and wore a bed alarm to help prevent future falls. The bed alarm would sound when Shrock would get out of bed without assistance so that his nurses could assist him. Padded mats were also placed on the floor for his protection.

Shrock's daughter, Kathleen Sakoguchi, frequently found her father without his bed alarm and the protective floor mats were removed after one week. Shrock, who was working towards returning home, fell on July 14, 2009. Bleeding from his head, he was found on the floor by a nursing assistant, who did not know how long he had been lying there. He died four days later.

On January 20, 2010, the California Department of Public Health fined the facility $85,000 for a July 14, 2009 incident. The company is appealing the citation. Shrock's family flied a lawsuit against Kindred Healthcare Operating, Inc. and Kindred Nursing Centers West, LLC on Tuesday, April 6, 2010, alleging that facility staff failed to adequate steps to prevent Shrock from falling, among other things.

The facility was sold in October 2009 and is now known as Orange Healthcare and Wellness Center.

We discussed the problems Somerset Place, a Chicago, Illinois nursing home, was experiencing in previous blogs. Somerset Place was home to more than 300 mentally ill residents and had been cited for repeated fights, verbal abuse, and lack of supervision, among other problems.

Reportedly, while admitting no fault, the owners of Somerset Place and the State of Illinois reached a settlement last month that is unpublicized. The owners of the facility agreed to pay fines totaling $20,000 and surrendered the facility's license. However, it is possible for the owners to renew the license because the state agreed that the settlement cannot be used to deny a license renewal.

Belle Plaine Nursing and Rehab Center was fined $10,000 for failing to assess a resident and provide timely care.

The fine is connected with a February 1, 2010 incident where a resident was found in bed with a fractured thighbone around 6:20 a.m. The resident suffered from dementia and osteoporosis, among other things. The facility, reportedly unaware of how the resident sustained the injury, was unable to offer an explanation. According to an orthopedic surgeon, the broken thighbone was the result of a trauma that could not have occurred while lying in bed. The injury was the result of a fall or twisting of the leg. After being treated at the hospital, the resident was returned to the facility.

On February 4, 2010, a hospice nurse noticed a large bump on the same resident's arm. The bump turned out to be another fracture. The resident died on February 5, 2010 with the death certificate listing cardiopulmonary failure and failure to thrive as causes of death.

According to an investigative report, the facility failed to assess the resident prior to administering morphine on February 1 around 12:20 a.m. after the resident was moaning and agitated. Staff reported that while anti-anxiety medications did not work for the resident the previous day, morphine was calming for the resident.

Nursing home operator Philip Esformes has reportedly been linted to a kickback scheme, an allegation he vehemently denies.

According to co-workers of Chicago physician Roland Borrasi, Borrasi told them that he made cash payoffs to Esformes in exchange for access to a pool of patients. Reportedly, Lynn Madeja, a medical biller for Borrasi, told government agents, "I got to give Phillip $1,000 or $10,000." Borrasi allegedly told Madeja that he "had to make it up" (with cash) to "use" Esformes patients.

Abhin Singla, a member of of Borrasi's medical group, cooperated with federal agents and wore a wire. He told federal agents that "Esformes controls the flow of patients in and out of his nursing homes to ensure that he is receiving the maximum allowed benefit." Reportedly, in a March 2001 incident, Singla was with Borrasi when Esformes called and told him to admit at least five nursing home residents to area hospitals. Borrasi did so without question, telling Singla "someone would find something wrong with the patients to justify the admissions".

While Esformes denies the allegations, Kimberly Reevas, a former Rock Creek psychiatric hospital discharge planner and social worker, helped unravel the scheme saying that Esformes was often at the hospital and was deeply involved in steering patients to his facilities. Further, Reevas said that Esformes told Rock Creek social workers that they were "only to send patients with public aid, public aid pending, disability, or Medicare".

Esformes and his father, Morris Esformes, were part of a group that paid the U.S. Justice Department $15.4 million in 2006 to settle civil claims of healthcare fraud and kickbacks. They deny wrongdoing and say they didn't contribute to the settlement.

A California nursing home caretaker accused an eighty-eight year old elderly woman of "enticing him into bed". Fifty year old Humberto Carrizales Rodriguez was the caretaker at Wild Rose Living Facility in Santa Rosa. On August 7, 2009, Rodriguez forced himself on his victim after she had gone to bed, while she begged him to stop. After pleading guilty, he was sentenced to six years in prison for her rape. Sadly, the victim's children testified at the sentencing hearing about the worsening of their mother's condition, how she is afraid of other men who live and work at the facility, and how they will find her crying for no reason at all. Rodriguez did not express remorse for his actions and basically blamed the victim for "enticing him into bed".

According to a Minnesota State Health Department report, a registered nurse at Woodbury Health Care Center, a nursing home located in Woodbury, Minnesota improperly ordered a halt to CPR on a resident, which resulted in the resident's death.

Reportedly, a facility staff member began CPR on the resident, who was in her 80s and suffered from breathing problems and breast cancer. The nurse, who was not identified, said, "She is dead." The individual administering CPR kept up resuscitation efforts until the nurse "raised her voice and repeated her command". The resident was dead before emergency responders could take over.

The nurse, who has a history of disciplinary actions, was fired. According to her personnel file, she had been cited for needing to improve her job knowledge, professionalism, and relationships with subordinates, residents, and families. In 2007, a doctor filed a formal complaint against her for improper conduct and in 2009, she failed to follow wound-management protocol and was disciplined.

On March 31, 2010, fourteen nurses and nurse aides at Northwoods Rehabilitation and Extended Care Facility, located outside of Troy, New York were charged with endangering the welfare of a resident plus felony falsification of business records. They were also charged with multiple misdemeanor violations of health laws.

Using video surveillance, Attorney General Andrew Cuomo showed a six week period of alleged neglect of the resident. According to a news release from Cuomo's office, the staff "routinely failed to turn and position an immobile resident, often leaving the resident in the same position for an entire shift. Nursing staff failed to administer medications, as well as treat the resident's bed sores. The footage also revealed that the aides charged failed to check the resident for incontinence or change undergarments for long periods of time." The report continued, saying, "In addition, the resident's medical records show that the defendants falsified medical records to conceal their neglect. A physician assistant also created a phony record of an annual medical exam that never happened."

Six LPNs, seven CNAs, and a physician assistant were charged on March 31, 2010.
Nine nurses and nurse aides currently working at the facility are being suspended until the charges are resolved.

Northwoods is no stranger to problems at the facility. The facility lost federal funding last year after facility workers routinely ignored the patient assistance buzzer. In January 2010, a male nurse aide at the facility pleaded guilty to sexually abusing a 78 year old female resident in 2008.

Did the owner and president of a Connecticut nursing home facility currently in bankruptcy loot the facility?

Stan Rodowicz, the owner and president of Village Manor was removed from the facility through a court order, according to the attorney general's office. The court order appointed a new CEO, Timothy Colburn, for the facility. The Court also appointed a trustee to audit the facility's books to investigate the allegation that approximately $329,000 was diverted from the bankrupt facility.

According to Attorney General Richard Blumenthal, Stan Rodowicz told the facility's attorney that he had diverted the funds by charging excessive rents. The facility, like many nursing home facilities, pays a separate company to rent the building that the nursing home is in. Rodowicz and his mother own that company as well.

The investigation continues and there are no plans to close the facility at this time.

A California man has been arrested and charged in connection with three sexual assaults at a California nursing home facility.

On February 16, 2010, twenty year old Christopher Richardson allegedly broke into the Heritage Rehabilitation Center in Torrence, California between 6 p.m. and 7 p.m. through an unlocked window and attacked the three residents. He was arrested a week later in connection with a similar assault.

Richardson faces charges of lewd acts against elderly, burglary, and elder abuse.

A shipment of Oxycodone was stolen from Ridgecrest Nursing and Rehabilitation on Sunday, April 4, 2010.

A shipment of thirty tablets of Oxycodone was delivered to the facility on Sunday around 9:00 a.m. An LPN signed for the delivery but became distracted by a situation that needed immediate attention. The LPN, Amanda Whalen, put the medication on a lower shelf in the nursing station until she could properly store them - leaving the painkiller unsecured in an area where housekeeping, nurses, residents, and guests all had access to the drugs.

She forgot about the shipment and when she returned several hours later to properly store them, the tablets were gone. The missing drugs were reported to the police by the nursing supervisor.

According to the Agency for Health Care Administration, it is unclear whether missing drugs would be something they would investigate. According to the News-Journal, the nursing home's inspection reports reveals that the facility was cited twice in 2009 for drug administration as being an issue requiring attention.

The facility is currently under investigation for a February 19, 2010 incident where a seventy-six year old resident died six days after she suffered two broken legs and a broken shoulder in a fall. Those injuries were left untreated for nearly 12 hours. To read more about this incident, see our blog.

We discussed alleged whistleblower retaliation at select Iowa nursing home facilities, including Windmill Manor in our March 25, 2010 blog. Reportedly, the Director of Nursing at Windmill Manor, a Coralville nursing home facility, threatened to fire seven facility employees if they reported any abuse or neglect violations to state inspectors. She reportedly told her staff that "she had a stack of applications" from prospective employees. She admitted to state investigators that she made the threat during a luncheon during Nurses' Appreciation Week but would not have carried through on it.

According to the Des Moines Register, the Iowa Department of Inspections and Appeals fined the facility $5,000 for the incident and referred the matter to Johnson County authorities for prosecution. The Director of Nursing, Karen Etter, now faces a criminal charge of attempting to impede or interfere with state inspections at the nursing home facility and is scheduled to appear in court on April 19, 2010. While her nursing license currently remains in good standing, she is no longer employed at Windmill Manor. In addition to the individual prosecution of Etter, she faces possible federal charges as investigators recently met with federal prosecutors about the possibility of federal charges or criminal sanctions against whistleblower retaliation offenders.

Windmill Manor now resides on the federal list of "special focus facilities" that have a history of noncompliance with health and safety standards. These facilities are subject to bi-annual inspections and closer review.

More information has come out about two other Iowa facilities that were fined for whistleblower retaliation around the same time as Windmill Manor. Granger Nursing and Rehabilitation Center was fined $5,000 for firing an employee that told state inspectors about equipment problems that occurred prior to a resident's death. Crossbridge Homes of Marshalltown was fined $1,000 when its former administrator, who faxed a list of concerns to the inspections department, was demoted.

Beacon Shores Nursing and Rehabilitation landed on the "Special Focus Facility" list belonging to the Centers for Medicare and Medicaid Services in February 2008. Special Focus Facilities are facilities that exhibit chronic problems that continue despite the opportunity to make improvements and are subject to two inspections per year.

The facility recently received notice that two state health agencies have begun proceedings that could end federal funding for the facility. Reportedly, despite opportunities to improve performance and care at the facility, the facility is still deficient in its care of residents.

A Virginia licensing board has accused two current NHC-Bristol staff members and a former nursing director of ignoring reports of sexual abuse and discouraging others from reporting allegations of sexual abuse.

The alleged abuser, James Wright, was a former nurse's aide at the facility. He entered an Alford plea to four counts of aggravated sexual battery. An Alford plea acknowledges that there is evidence sufficient to convict the defendant without admitting guilt and is treated as a guilty plea by the court.

NHC - Bristol Administrator Charlotte Wilson, Nursing Supervisor Helen Roberts, and former Nursing Supervisor Elizabeth Franklin are accused of ignoring sexual abuse allegations and discouraging sexual abuse reporting. Wilson is accused of failing to investigation reports of sexual abuse of residents between 2000 and 2008; her failure affected twelve residents. She is also accused of failing to pass on reports to resident's physicians or to Adult Protective Services. Wilson reportedly set up a chain of command to dead end abuse reports, which is a violation of state law.

Both Roberts and Franklin attempted to discourage a resident's daughter from filing a complaint surrounding sexual abuse.

Reportedly, abuse has been uncovered at another Good Samaritan facility, Good Samaritan Bethany, located in Brainerd, Minnesota. You will recall that the Good Samaritan facility located in Albert Lea was in the public eye after several teenage CNAs reportedly sexually, emotionally, and physically abused elderly defenseless residents.

The facility was recently cited for four rule violations surrounding the maltreatment of residents, failing to protect them, and a violation for neglect of supervision and faces a $5,000 fine.

State investigators entered the facility on December 11, 2008 and were told by administrators that one aide might have mistreated several dementia residents. Instead, investigators were shocked to uncover a "pattern of resident abuse" by as many as 20 nursing assistants. The abuse included belittling elderly residents, removing a call-light from a confused resident, and telling a male resident to urinate in his incontinence briefs. Investigators also found that aides swore at residents or punished the residents by refusing them coffee. The alleged mistreatment had been going on for more than three months and as many as 40 employees knew of the abuse, including supervisors.

The facility was slapped with an "immediate jeopardy" citation and was forced to retrain staff immediately or lose federal funding.

According a recent complaint investigation by the Illinois Department of Public Health, Manor Court of Clinton, a nursing home facility located in Clinton, Illinois, failed to meet several federal standards and faces a daily $400 fine until the deficiencies are corrected.

According to the investigation report, Manor Court failed to:

- Maintain hot water;
- Relieve pressure sores;
- Prevent a fall;
- Administer and monitor some medications for residents; and
- Have sufficient staff on hand.

According to the East Central Illinois Area Agency on Aging regional ombudsman, the agency had filed multiple complaints with the administrator of the facility, but "while we were responding to complaints, the attitude and lack of cooperation we received from the administrator was concerning". That administrator has since been replaced.

The Terry Law Firm handles cases involving abuse and neglect in Illinois nursing homes. If you are interested in learning more about nursing home abuse in Illinois, request a free copy of my new book "5 Things You Must Know About Nursing Home Abuse and Neglect in Illinois" here

We discussed Caesar Ulloa and his alleged abuse of defenseless nursing home residents in previous blogs. Ulloa, who is only 21 years old, was charged with one count of torture and seven counts of elder abuse. If convicted, he faces life in prison.

Reportedly, Ulloa preyed on defenseless nursing home residents under his care at the Silverado Senior Living facility in Calabasas, California. A co-worker, Adelina Campos, testified that she watched in horror while Ulloa jumped from a dresser onto a male resident, landing with his knees in the resident's stomach. Another former co-worker, Luz Alvarez, saw Ulloa punch a combative wheelchair-bound resident in the stomach while asking "Haven't you had enough?" Ulloa reportedly also attacked a 78 year old woman by body-slamming her and encouraging two wheelchair-bound residents to fight.

Ulloa finally came under suspicion in the death of resident Elmore Kittower. The day after Mr. Kittower was buried, his widow received a call from Aldeina Campos' mother, who told Mrs. Kittower that her husband had been beaten to death. His body was exhumed and several broken bones were discovered. An autopsy found that blunt force trauma contributed to cause his death.

Ulloa, a former employee of the month, was fired from the facility in 2008 for reasons unrelated to resident abuse and has been in jail since his 2008 arrest.

Eighty-five year old Paul Reuter, Jr. began showing significant changes in respiration early in the morning on September 30, 2009. Reuter, a resident of Littlefork Medical Center, a Minnesota nursing home facility, died around 5:00 a.m. that day.

A licensed practical nurse at the facility, who remains unnamed and is still employed at the facility, discovered Reuter's low oxygen levels around 12:40 a.m. She failed to consult a registered nurse before connecting him to supplemental oxygen, which appeared to be helping Mr. Reuter's oxygen levels to rise. She checked him twice more, at one hour intervals, before finding him dead at 5:00 a.m.

According to the investigative report, although trained on the proper procedures to follow, the LPN failed to follow established facility procedure when the resident's condition began to deteriorate. When questioned why she did not follow procedure, the LPN said she thought the RN would tell her to put oxygen on the resident and monitor him. She did not believe she neglected the resident.

The LPN was suspended for five days without pay and was disciplined. She was also required to re-train on appropriate reporting and watch a video on critical thinking.