More Information and Illinois Nursing Home Stats from IDPH Report

Yesterday we shared information on the latest report available from the Illinois Department of Public Health on the State of Long-Term Care in Illinois. The report is far from perfect, but all those concerned about the care for seniors and those with disabilities in our state are well served by taking a look at the full research effort. It is helpful to identify trends and get a feel for the various issues that are affecting the industry, from staffing rates to reported instances of neglect.

In our previous post we discussed the steady total level of long-term care facilities, IDPH employee levels, and basic neglect and abuse trends. Some other interesting details to pull from the report include:

–The report indicates various citations issued to facilities. There are several types of citations, “A,” “Repeat A,” “B,” and “Repeat B.” These refer to the supposed severity of the problem at the facility and whether or not it is an on-going issue. The statistics on this front are somewhat interesting. For example, in 2007 there were 177 “Type A” violations issued–the more severe type of care problem. The following year, the same total dropped to 97. And then in 2009 the Type A violations count rose significantly to 214.

What is responsible for this yo-yo effect? It seems unlikely that the average quality of care at long-term care facilities would improve suddenly in 2008 and then deteriortae rapidly in 2009. Instead, the change is likely attributable to changes in inspection protocols and enforcement routines which increased the liklihood of a facility facing a citation in 2009 as opposed to 2008. In other words, the actual care received by residents on a daily basis over this time was unlikely to change. Understanding these sorts of issues is crucial to not reading too much into the year over year statistics on this front.

–The “Type B” violations followed the same trend over these three years: decreasing in 2008 and then jumping significantly in the following year.

–Interestingly, there are few instances of repeat cititations. There were 7 Repeat B violations and 2 Repeat A violations in 2007. In 2008 there were zero repeat citations issued. The following year, in 2009, those rose to 3 and 1 respectively. Either facilities are very quick to improve care permanently after being issued a citation or they are quick to show improvemet for regulators before slipping back into old practices. It is hard to make definitive judgmennts on these issues from the information provided in this report.

–Notwithstanding the total number of citations issues, the report makes clear that a violation resulting in a permanent loss of license is rare. For example, in 2007 only 3 facilities were denied a license after a violation. There was 1 denial or revocation in 2008, and 3 again in 2009.

–Beyond the numbers, the report also includes helpful summaries of the review and monitoring process for the regulatory agency. They detail how the law allows them to issue fines, seek denial of licenses, and other tools to ensure proper care is being received by all those in these care settings.

If you or someone you know may not have recieved proper care in a nurisng home in Chicago or throughout Illinois. Please take a moment to contact our office to see how we can help. Our team of attorneys works with families throughout the state who have suffered falls, developed bedsores, faced a resident-on-resident attack or any number of other issues at a long-term care facility.

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Nursing Home Neglect & Medical Malpractice

Basic Illinois Nursing Home Statistics & Annual Summaries

When working with individuals and families hurt by nursing home negligence and misconduct, it is easy to get bogged down in case summaries. While individual stories are a vital component to the reality of nursing home care in Illinois, it is also helpful to examine more universal trends. After all, it is only by comparing system-wide data year over year that we are able to understand whether real impacts for the better are being made. For example, are citations going down? Are there more or fewer complaints to state officials from residents and their families? All of this provides a helpful indicator of where were are and where we need to go.

Unfortunately, it is notoriously difficult to accurately collect and report this information. For that reason, it is important to take most universal summaries with a grain of salt. Instead, they are best utilized for their trends–are things going up or down–rather than their “to the number” accuracy.
However, that is not to say that there are not helpful publications out there which attempt to explain the overall picture of nursing home care in Illinois with real statistics. Perhaps the most comprehensive of these is the annual report created by the Illinois Department of Public Health (IDPH) to the General Assembly on the State of Long-Term Care. This report is required by the Illinois Nursing Home Care Act, though the most current report available for viewing online is from 2010.

Illinois Nursing Home Care Stats
The IDPH report offers a wide range of interesting statistics which help provide important persepctive on the state of long-term care in Chicago and throughout Illinois. Some of the more fascinating findings include…

–The total number of long-term care facilites in the state (when the definition is viewed expansively) has actually decreased slightly from 2007 to 2010–from 1,274 to 1,262. However, the number of skilled nursing facilities (most commonly viewed as traditional nursing homes) increased slightly during that same period, from 428 to 452. These trends are important, as there is a well-known demographic shift coming, with an aging population and a likely need for more resources on this front. Perhaps most alarmingly, when all types of long-term care facilities are taken into account, the total bed count over this period decreased from 127,620 to 120,693. Considering the likely increase in need for these services, those numbers will need to turn around.

–At the start of 2010, the IDPH had 204 staff members devoted to license and certification processes, and 9 staff members on quality control. Staffing rates for various regulatory functions are important, because there is often concern about whether or not there are adequate state resources to properly ensure nursing home laws are followed.

–The state reporting of abuse, neglect, and theft committed by nursing home aides shows an interesting trend over the past fews year, if accurate. For example, the report indicates that instances of outright abuse reported to its office from aides declined from 492 in 2006 to 107 in 2009.
That same significant drop was mirrored in individual rates of complaints for physical abuse, sexual abuse, and mental abuse. Similarly, reports of neglect dropped from 39 in 2006 to 13 in 2009. Theft complaints also dropped, though less notably, from 33 to 26 over that same period.

It is critical to point out with regard to these abuse and neglect statistics, that they do not represent an unimpeachable pronouncement on the total instances of mistreatment. The report itself notes that “it cannot be determined whether facilities report all allegations of abuse, neglect, or misappropriation of property by aides.” The sad reality is that many instances of neglect and abuse will never reach the IDPH and be included in this documentation. But that does not mean that those instances of poor care cannot result in civil liability.

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Updates on Fungal Meningitis Outbreak in Illinois

The furor over the mass outbreak of fungal meningitis continues. The U.S. Centers for Disease Control and Prevention issued updated information recently on the scope of the outbreak. According to their tallies, at least 480 patients have developed fungal meningits because of the contaminated epidural shots that they received. The death toll has also risen, with 33 individuals having died from meningitis complications. In most cases the deaths were caused by the patient suffering a stroke which was spurred by the fungal infection. We know that at least two of the infected patients are in Illinois. When the outbreak first made national news, officials from the Illinois Department of Public Health explained that three facilies (two in Chicago and one in Westerchester) were known to have distributed the steroids to patients. All told about 350 Illinois patients likely received the tainted shot.

Fury Over Lack of Oversight
In the months since the outbreak there has been growing concern regarding the apparent lack of oversight at the New England Compounding Center (NECC). Several members of Congress have begun asking tough questions of state and federal officials to better understand what went wrong and what should be done to prevent repeat occurrences.

A recent NBC News story on the topic delved into the regulatory confusion and the stark reality that, without changes, a similar problem could develop again. In fact, the U.S. Food and Drug Administration sent a letter to members of Congress admitting that they currently have little information about the state of pharmaceutical compounding facilities across the country. That is because most of the regulation falls to individual states, without comprehensive federal oversight. As such, each state is free to make its own decisions about the strictness of regulations and the punishments for past problems.

For example, officials were on notice for at least a decade of possible problems at the NECC. Past safety violations were documented, but little was done to ensure the problems were fixed and no future problems develped. In fact, at the time of the outbreak, the facility was operating beyond the scope of its state license. According to reports, the facility was not supposed to be mass producing and shipping drugs. But it was, and those operations are what led to the current crisis. Should state regulators have know about the facility’s breaches? Could it have done anything to stop it? Those are questions that many are now asking and that might lead to legisltive changes in the coming months.

Also, members of Congress are not pinning the problem only on state regulators. The U.S. FDA was also made aware of various problem years before. At a hearing on the issue, one Senator listed a string of citations, past contaminations, and sick patients that were tied to problems at the NECC. All of those issues were reported to the FDA. Yet, the only thing that the agency did, after several violations, was send a warning letter. Little to nothing was done to actually hold the wrongdoers accountable and ensure patients were not exposed to long-term risks as a result of chronic safety and sterilization problems at the plant.

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New Case of Fungal Meningitis in Illinos

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The Scope of the Illinois Nursing Home Anti-Psychotic Drug Problem

Yesterday we discussed the “blockbuster” lawsuit alleging hundreds of thousands of instances of Medicare and Medicaid fraud by a Chicago doctor at nursing homes in the area. The case is a perfect testament to the real scope of the overmedication problem in nursing homes. A close look at the details of the case make clear how extensive the problem was–it is shocking that this sort of thing did not raise red flags sooner.

The full complaint in the case can be found here.

Universal Nursing Home Over-Medication
The main issue is that the doctor allegedly made decisions about prescriptions to patients based on money he received from the pharmaceutical company which made the drug. The Chicago Tribune summarized the situation by noting that the the doctor had a strong proclivity to prescribe the drug Clozaril. The drug was manufactured by Novartis. Not surprisingly, for a time Novartis actually paid the doctor to promote the drug. During that time the doctor had thousands of patients on Clozaril. In 1998 the pharmacetical company’s patent on the medication ran out, however, the doctor resisted efforts to switch patients to far cheaper generic versions of those drugs. Throughout this time he was the “largest prescriber of Clozaril to Medicaid recipeients in the United States.”

It seems that the doctor’s attachment to the drug was less due to its benefits to patients and more to the benefits to his own bottom line. When the company, Novartis, decided to stop promoting the drug and making payments to the doctor, the doctor decided to convince makers of the generic drug to provide him resources in exchange for switching patients over to the generic version.

According to the lawsuit, the manufacturer of the generic drug, Ivax Pharmaceuticals, agreed to meet the doctor’s conditions. That included a $50,000 a year “consulting agreement,” payment to his nurse to speak about the drug, and funding of a “research study” connected to the doctor at the Uptown Research Institute.

After the agreement was made, the doctor began switching his patients from Clozaril to the generics. Just like before, he began leading the nation in use of the drug. Subtlety was not in his protocol. Apparently, national averages suggest that about 4% of patients with schizophrenia were prescribed the drug–generic or otherwise. However, at times nearly half of the defendant-doctor’s patients, 50%, were on the drug. That means that his prescription rate was well over 12 times the national average.

Patient Needs Not Considered
So where did the patients fit into all of this? Who knows. It seems like that actual needs and best interests of the vulnerable patients–most of them Chicago nursing home residents with cognitive ailments–were of little importance. If the allegations made in the federal lawsuit are to be believed, then the residents were nothing more than pawns to be used by the doctor to benefit himself.

The distorted priorities highlighted by this high-profile case is indicative of the underlying problem with so much nursing home abuse and neglect. Patients needs are sacrificed to the profit-margins of higher up decision-makers. From the overmedication of residents to low staffing levels, maximizing profit for others is never an acceptable excuse for providing less than reaosonable care to each and every nursing home resident in a facility.

See Our Related Blog Posts:

Nursing Homes, Public Funds, and Overbilling

Nursing Home Medicaid Kickback Lawsuit

The Scope of the Illinois Nursing Home Anti-Psychotic Drug Problem

Yesterday we discussed the “blockbuster” lawsuit alleging hundreds of thousands of instances of Medicare and Medicaid fraud by a Chicago doctor at nursing homes in the area. The case is a perfect testament to the real scope of the overmedication problem in nursing homes. A close look at the details of the case make clear how extensive the problem was–it is shocking that this sort of thing did not raise red flags sooner.

The full complaint in the case can be found here.

Universal Nursing Home Over-Medication
The main issue is that the doctor allegedly made decisions about prescriptions to patients based on money he received from the pharmaceutical company which made the drug. The Chicago Tribune summarized the situation by noting that the the doctor had a strong proclivity to prescribe the drug Clozaril. The drug was manufactured by Novartis. Not surprisingly, for a time Novartis actually paid the doctor to promote the drug. During that time the doctor had thousands of patients on Clozaril. In 1998 the pharmacetical company’s patent on the medication ran out, however, the doctor resisted efforts to switch patients to far cheaper generic versions of those drugs. Throughout this time he was the “largest prescriber of Clozaril to Medicaid recipeients in the United States.”

It seems that the doctor’s attachment to the drug was less due to its benefits to patients and more to the benefits to his own bottom line. When the company, Novartis, decided to stop promoting the drug and making payments to the doctor, the doctor decided to convince makers of the generic drug to provide him resources in exchange for switching patients over to the generic version.

According to the lawsuit, the manufacturer of the generic drug, Ivax Pharmaceuticals, agreed to meet the doctor’s conditions. That included a $50,000 a year “consulting agreement,” payment to his nurse to speak about the drug, and funding of a “research study” connected to the doctor at the Uptown Research Institute.

After the agreement was made, the doctor began switching his patients from Clozaril to the generics. Just like before, he began leading the nation in use of the drug. Subtlety was not in his protocol. Apparently, national averages suggest that about 4% of patients with schizophrenia were prescribed the drug–generic or otherwise. However, at times nearly half of the defendant-doctor’s patients, 50%, were on the drug. That means that his prescription rate was well over 12 times the national average.

Patient Needs Not Considered
So where did the patients fit into all of this? Who knows. It seems like that actual needs and best interests of the vulnerable patients–most of them Chicago nursing home residents with cognitive ailments–were of little importance. If the allegations made in the federal lawsuit are to be believed, then the residents were nothing more than pawns to be used by the doctor to benefit himself.

The distorted priorities highlighted by this high-profile case is indicative of the underlying problem with so much nursing home abuse and neglect. Patients needs are sacrificed to the profit-margins of higher up decision-makers. From the overmedication of residents to low staffing levels, maximizing profit for others is never an acceptable excuse for providing less than reaosonable care to each and every nursing home resident in a facility.

See Our Related Blog Posts:

Nursing Homes, Public Funds, and Overbilling

Nursing Home Medicaid Kickback Lawsuit

The Scope of the Illinois Nursing Home Anti-Psychotic Drug Problem

Yesterday we discussed the “blockbuster” lawsuit alleging hundreds of thousands of instances of Medicare and Medicaid fraud by a Chicago doctor at nursing homes in the area. The case is a perfect testament to the real scope of the overmedication problem in nursing homes. A close look at the details of the case make clear how extensive the problem was–it is shocking that this sort of thing did not raise red flags sooner.

The full complaint in the case can be found here.

Universal Nursing Home Over-Medication
The main issue is that the doctor allegedly made decisions about prescriptions to patients based on money he received from the pharmaceutical company which made the drug. The Chicago Tribune summarized the situation by noting that the the doctor had a strong proclivity to prescribe the drug Clozaril. The drug was manufactured by Novartis. Not surprisingly, for a time Novartis actually paid the doctor to promote the drug. During that time the doctor had thousands of patients on Clozaril. In 1998 the pharmacetical company’s patent on the medication ran out, however, the doctor resisted efforts to switch patients to far cheaper generic versions of those drugs. Throughout this time he was the “largest prescriber of Clozaril to Medicaid recipeients in the United States.”

It seems that the doctor’s attachment to the drug was less due to its benefits to patients and more to the benefits to his own bottom line. When the company, Novartis, decided to stop promoting the drug and making payments to the doctor, the doctor decided to convince makers of the generic drug to provide him resources in exchange for switching patients over to the generic version.

According to the lawsuit, the manufacturer of the generic drug, Ivax Pharmaceuticals, agreed to meet the doctor’s conditions. That included a $50,000 a year “consulting agreement,” payment to his nurse to speak about the drug, and funding of a “research study” connected to the doctor at the Uptown Research Institute.

After the agreement was made, the doctor began switching his patients from Clozaril to the generics. Just like before, he began leading the nation in use of the drug. Subtlety was not in his protocol. Apparently, national averages suggest that about 4% of patients with schizophrenia were prescribed the drug–generic or otherwise. However, at times nearly half of the defendant-doctor’s patients, 50%, were on the drug. That means that his prescription rate was well over 12 times the national average.

Patient Needs Not Considered
So where did the patients fit into all of this? Who knows. It seems like that actual needs and best interests of the vulnerable patients–most of them Chicago nursing home residents with cognitive ailments–were of little importance. If the allegations made in the federal lawsuit are to be believed, then the residents were nothing more than pawns to be used by the doctor to benefit himself.

The distorted priorities highlighted by this high-profile case is indicative of the underlying problem with so much nursing home abuse and neglect. Patients needs are sacrificed to the profit-margins of higher up decision-makers. From the overmedication of residents to low staffing levels, maximizing profit for others is never an acceptable excuse for providing less than reaosonable care to each and every nursing home resident in a facility.

See Our Related Blog Posts:

Nursing Homes, Public Funds, and Overbilling

Nursing Home Medicaid Kickback Lawsuit

Lawsuit Filed Alleging Kickbacks for Nursing Home Anti-Pyschotic Drug Use

The Chicago Tribune reported last week on a shocking new lawsuit against a Chicago phsyciatrist alleging severe misconduct, fraud, and “assembly-line” care to Illinois residents with mental illnesses. The federal suit is one of the largest ever filed against a single individual related to prescription drug fraud. It is a terribly tragic reminder the tens of thousands of vulnerable patients whose lives can be harmed (or even taken altogether) as a result of the greed, sloppiness, and lack of care by even a single healthcare provider.

Decades of Over-Medication of Residents in Chicago
According to the story, Dr. Michael J. Reinstein had an office in the Uptown neighborhood of Chicago and worked with thousands of residents, including many with mental illnesses in Chicago area nursing homes. However, if the allegations in the lawsuit are true, Dr. Reinstein’s care may have proven incredibly deadly, costly, and ineffective. The suit claims that a shocking 140,000 false Medicare and Medicaid claims were filed by the doctor over the years. The claims stem almost exclusively from prescribing anti-psychotic drugs to patients in nursing homes.

In recent years we have argued exhaustively on the dangers of over-prescribing these drugs. The FDA has issued a black box ruling on the increased risk of death when these drugs are given to residents with dementia. On top of that, the over-reliance on these medications among all nursing home residents often means that individuals who can be cared for in other ways, with fewer side effects, do not received the adaptive care available to maximize their well-being without drugs. The bottom line is that use of anti-psychotics in nursing homes remains a serious problem, and this latest case is a clear representation of that problem.

Kickbacks for Prescriptions to Illlinois Nursing Home Residents
The federal lawsuit includes allegations that the doctor made decisions about drug prescriptions based on his own bottom line. Instead of taking each patient individually and assessing whether the drugs were completely necessay and safe, the doctor instead made choices so that he could make more money. That included taking kickbacks from the pharmaceutical companies themselves under the understanding that he would prescribe those medications to patients. This situation represents the absolute worst of medical caregiving, steeped in self-interest with little to no consideration for the vulnerable individuals whose lives hang in the balance.

Residents in nursing homes with mental illnesses in Illinois are at the complete mercy of those charged with their care. When those individuals prioritize their own interests over the safety of residents, there must be full accountability. This sort of conduct cannot stand.

If you ever suspect that a medical caregiver is making medication choices against the best wishes of the patient, be sure to seek out legal help to learn more. Even a single doctor can cause thousands of patients unnecessary harm and suffering. They must be rooted out. The nursing home lawyers at our firm have spent decades working on protecting the rights of residents who do not receive the care to which they are entitled. That includes everything from negligent supervision of residents with dementia to the over-medication of patients which leads to harm.

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State High Court Decision Allows Nursing Home Case to Proceed

Most states, including Illinois, have legal requirements regarding a set amount of “nursing hours” that each nursing home resident must receive on a daily basis at the facility. There are many different requirements regarding the specific-format of those hours. However, the underlying principle in all of the requirements is simple: there must be enough qualified staff members at the facility at all times to provide the level of care that the residents need. As we often explain, understaffing is at the root of so many instances of neglet that lead to serious injury or even wrongful death at these homes.

However, even though many states have these laws, they are often flagrantly violated. After all, it is somewhat difficult to monitor the detailed hourly work at individual facilties. Often, it is only after a serious event that causes injury occurs that these details are checked into. As a result, many residents are still allowed to suffer harm because the nursing requirements are not abided by and fail to actually prevent the harm before it occurs.

Suing for Violating Nursing Hours Requirements at Nursing Homes
For that reason some advocates are trying to be proactive and hold these facilties accountable for violating the requirements. Unfortunately, however, there are a range of legal complexities invovled with private citizens seeking to enforce public regulations. In most cases, that enforcement must come from the govenment itself.

Those legal details have been the centerpiece of some recent state litigation on the topic. Fortunately, resident- safety advocates have won a few legal victories. For example, SF Gate reported on how the state supreme court in California recently ruled that residents of the several facilities can sue a group of homes for violating those state nursing requirements. In particular, the plantiffs in the case allege that the owners of the home failed to meet the 3.2 hours of care per day requirement over a period of four years. The case includes allegations that the facilities were below that required mark at least 35% of the time for the four years beginning in December of 2006.

In earlier hearings, the defendant facilities argued that the law which set up the nursing staff requirements did not authorize private lawsuits. A trial level court agreed with the defendants. However, that ruling was reversed at the first appellate level with the three judge panel ruling unanimously that the residents were able to seek accountability. The ruling noted that the law allows nursing home residents “to bring actions themselves to remedy violations of their rights, [which included the] right to reside in an adequately staffed facility.” That reversal was itself appealed by the defendants to the state’s highest court. However, recently that court refused to hear the appeal. That means that the lower court ruling stands and the residents’ case will be able to proceed.

This matter is a big deal, because without private enforcement, it is unlikely that the spirit of the law will be respected. That is because, as in most states, the public departments charged with ensuring the law is followed do not have the resources to ensure compliance. The practical effect is nearly the same as if the law hadn’t been pass at all. Hopefully, however, with private enforcement nursing homes will actually be forced to abide by the law and ensure adequate resources are available to residents.

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Consumer Voice on Election Results and Long-Term Care

Somebody Call 911!

Families with loved ones in adult care facilities are pushing for new legislation that will affect how the facilities handle missing patient situations according to a recent article in the Mercury News. The legislation is not up for a vote yet, but if enacted, the law will require care facilities to contact authorities immediately once a resident is discovered missing or has failed to return at a scheduled time.

The two incidents highlighted in the article involve situations where mentally impaired adults went missing for several hours from the facilities whose care they were under. The facilities did not act quickly in either case.

Yolanda Membreno was an 86-year-old mentally impaired woman under the care of Julia’s Home. She went missing from the home on September 30th of this year. According to Roy Roberto, the man who operates Julia’s Home, their established protocol is to conduct their own search before contacting the police. In Membreno’s case, the staff followed protocol but that meant waiting an hour before contacting the police. Membreno was found dead on a playground only 100 yards away from the entrance to the care facility just a few hours after she went missing.

Caitlin Lester is a 24-year-old developmentally disabled woman who was under the daytime care of the Concord House. Caitlin’s mother arrived on the evening of July 15 at the Concord House to pick up Caitlin. Caitlin was not there. She and two other patients had been allowed to walk to Starbucks just a few blocks away. They were three hours past their expected return time, but the staff at the Concord House had not noticed that they were still gone. Two Catholic nuns run the Concord House, and once Caitlin’s mother arrived to find her daughter missing, Sister Maryanne Leyba called the police for the first time. Fortunately, a good Samaritan found the three missing patients, but by the time they were found they were seven miles away from the home.

Caitlin survived the ordeal, but the walk resulted in post-traumatic shock and bloody wounds on her thighs. Doctors also discovered a severe urinary tract infection and that Caitlin was going into septic shock according to her mother.

In Membreno’s case, the care facility followed their protocol and did contact the police, but it was too late. Roberto, the facility’s operator, did say that he would be open to new laws requiring him to call the police immediately. In Caitlin’s case, the nuns did not notice Caitlin and the others were missing. According to the article, the Concord House broke the law requiring them to call the Community Care Licensing Division by failing to report a missing person. Both cases show that there is a “gap” in the regulations controlling residential adult care facilities. Pat McGinnis, founder of California Advocates for Nursing Home Reform, said that such a law requiring facilities to contact the police immediately is “a good start.” The law that Caitlin’s mom is supporting focuses on adult care facilities that are regulated by the Community Care Licensing Division under the California Department of Social Services, but does not include skilled-nursing facilities licensed by the California Department of Health and Human Services.

There were 1,932 reports of missing dependent adults in 2011 in California, according to the California Department of Justice. Many of these cases result in injuries, or even death like that in Membreno’s case. It is not a guarantee that notifying the authorities immediately will cut down on this number, but having the police respond immediately will ensure that every measure is being taken to find and protect dependent adults who go missing. If you have a loved one who was injured in a similar situation, please contact our elder law attorneys to discuss your case.

Please See Our Related Blog Posts:
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Somebody Call 911!

Families with loved ones in adult care facilities are pushing for new legislation that will affect how the facilities handle missing patient situations according to a recent article in the Mercury News. The legislation is not up for a vote yet, but if enacted, the law will require care facilities to contact authorities immediately once a resident is discovered missing or has failed to return at a scheduled time.

The two incidents highlighted in the article involve situations where mentally impaired adults went missing for several hours from the facilities whose care they were under. The facilities did not act quickly in either case.

Yolanda Membreno was an 86-year-old mentally impaired woman under the care of Julia’s Home. She went missing from the home on September 30th of this year. According to Roy Roberto, the man who operates Julia’s Home, their established protocol is to conduct their own search before contacting the police. In Membreno’s case, the staff followed protocol but that meant waiting an hour before contacting the police. Membreno was found dead on a playground only 100 yards away from the entrance to the care facility just a few hours after she went missing.

Caitlin Lester is a 24-year-old developmentally disabled woman who was under the daytime care of the Concord House. Caitlin’s mother arrived on the evening of July 15 at the Concord House to pick up Caitlin. Caitlin was not there. She and two other patients had been allowed to walk to Starbucks just a few blocks away. They were three hours past their expected return time, but the staff at the Concord House had not noticed that they were still gone. Two Catholic nuns run the Concord House, and once Caitlin’s mother arrived to find her daughter missing, Sister Maryanne Leyba called the police for the first time. Fortunately, a good Samaritan found the three missing patients, but by the time they were found they were seven miles away from the home.

Caitlin survived the ordeal, but the walk resulted in post-traumatic shock and bloody wounds on her thighs. Doctors also discovered a severe urinary tract infection and that Caitlin was going into septic shock according to her mother.

In Membreno’s case, the care facility followed their protocol and did contact the police, but it was too late. Roberto, the facility’s operator, did say that he would be open to new laws requiring him to call the police immediately. In Caitlin’s case, the nuns did not notice Caitlin and the others were missing. According to the article, the Concord House broke the law requiring them to call the Community Care Licensing Division by failing to report a missing person. Both cases show that there is a “gap” in the regulations controlling residential adult care facilities. Pat McGinnis, founder of California Advocates for Nursing Home Reform, said that such a law requiring facilities to contact the police immediately is “a good start.” The law that Caitlin’s mom is supporting focuses on adult care facilities that are regulated by the Community Care Licensing Division under the California Department of Social Services, but does not include skilled-nursing facilities licensed by the California Department of Health and Human Services.

There were 1,932 reports of missing dependent adults in 2011 in California, according to the California Department of Justice. Many of these cases result in injuries, or even death like that in Membreno’s case. It is not a guarantee that notifying the authorities immediately will cut down on this number, but having the police respond immediately will ensure that every measure is being taken to find and protect dependent adults who go missing. If you have a loved one who was injured in a similar situation, please contact our elder law attorneys to discuss your case.

Please See Our Related Blog Posts:
Elder Abuse Investigations: Coming Soon to a Care Center Near You
Protection from an Abusive Caregiver