Nursing Home Abuse

Reports of abuse and neglect are hidden and uninvestigated

California’s Department of Public Health (CDPH) had a problem: a big backlog of reports of abuse, neglect or theft.

The state agency is charged with investigating any claims that nursing assistants and home health aides have abused, neglect, or otherwise mistreated patients.

Five years ago, nearly 1000 of those claims were quietly closed.

The Center for Investigative Reporting looked into this and determined that since 2009, most of claims of abuse, neglect and theft reported to the CDPH have been closed after very limited investigations. The public health investigators were never contacting the victim, or even leaving the office to look into claims.The_center_for_investigative_Reporting

Sometimes, they were simply closing cases —without any review or investigation at all.

Because of this tactic, the Center for Investigative Reporting found limited information about the closed abuse and neglect claims. But they did find hundreds of uninvestigated reports of:

  • Serious injuries
  • Suspicious deaths
  • Physical and sexual assaults

In many of these claims, caregivers were not only never punished; but also, kept their licenses and moved on to other facilities.

Putting “elderly, sick and disabled” at risk

CDPH has the duty of protecting vulnerable patients.

Instead, their actions are putting thousands of people at risk. Health care workers who were accused of harming patients are still out there, and still working.

Statewide, public health investigators in 2012 finished 81 percent of their cases without taking action against an accused caregiver, up from 58 percent in 2006.

See The Center for Investigative Reporting: Quick dismissal of caregiver abuse cases puts Calif. Patients at risk

Many elderly or infirm victims will never get justice in California. The victims and their families may never even know what happened to their claims.

This shocking report reminds us that it is crucial for people to have the ability to sue when they are harmed by nursing home abuse or neglect. Unfortunately, that right is being eroded every day.

Frontline’s/ProPublica’s Life and Death in Assisted Living

Toward the end of July, Frontline in partnership with ProPublica began airing a series, Life & Death in Assisted Living; its full transcript is now available via ebook. With the increasing numbers of seniors who reside in assisted living facilities, an alarming number of stories of neglect and abuse have surfaced. Frontline investigators delved into case studies, offering insights about problems with this loosely regulated multi-billion dollar industry.

Frontline's series "Life & Death in Assisted Facilities" is running on PBS and also available as an ebook.

Frontline’s series “Life & Death in Assisted Living” is running on PBS and a full transcript is also available as an ebook. assisted living facilities, Frontline/ProPublica (PP) investigated this loosely regulated multi-billion dollar industry.

The series began with a focus on the tragic story of Joan Boice, which I blogged about earlier this spring. Frontline compared and contrasted the Seattle based assisted living facility’s marketing pitch with reality.

For example, “specially trained” staffers weren’t really trained to  care for people with Alzheimer’s and other forms of dementia, a violation of California law. At its best, there was only one nurse to track all of the residents’ health. The turnover of medical professionals was high. In fact, one of them who left wrote Emeritus’ senior executives about the facility’s “ huge shortage of staff” and that the facility was mired in “total dysfunction.”

emerald hills brochure


Apparently, there were months when a full-time nurse was not even on the facility’s payroll. Residents with incontinence issues were allowed to urinate repeatedly in the same spot in a hallway repeatedly.

But Ms. Boice’s husband and two sons saw only the facility as it was presented, as a respite for their aging mother who suffered from Alzheimer’s. They agreed to pay over $4,625 a month for Joan to receive care as a resident at the Emerald Hills facility and another $2,500/month for her husband.

Less than two weeks after Joan moved in, an ambulance crew found her face-down on the carpet. She had struck her head on the floor with such force that she had bruises on her forehead and cheeks. No one at Emerald Hills, however, knew how Joan had fallen or how long she had been laying on the floor. She had defecated and urinated on herself.

Although Myron, Joan’s husband, was also a resident at the facility, no one informed him about this startling event as Joan was transported to the hospital without any facility employee to accompany her. Joan’s son, Eric, got the call from the hospital later that night.

California law requires assisted living companies to conduct a “pre-admission appraisal” of prospective residents, to ensure they are appropriate candidates for assisted living. However, the assisted living facility never conducted the appraisal of Joan. They failed to consider Joan’s family’s warnings before her move in: They had warned Emerald Hills that Joan shouldn’t sit in a chair without supervision, given her history of losing her balance whenever she would get up. But despite this warning, Joan’s daughter-in-law would visit Joan to find her sitting by herself in a chair without anybody else in the room.

The Frontline investigation exposes the gaps in the law that have allowed assisted living and nursing home facilities like Emeritus’ Emerald Hills to endanger and kill senior citizens like Mrs Boice.


Nursing Home Statistics

I was ran across this info at the American Association for Justice website, and thought it was worth republishing here.

Nursing Homes by the Numbers

Scope of Abuse and Neglect
Percentage of U.S. nursing homes with staffing levels too low to provide adequate care. 90%
Profit Motives and Care
Suspicious accounting transactions identified by U.S. News & World Report in 2000. $3.4 billion
Drop in nurse assistants’ hours per resident per day. 16%
1.4 million  —  Current number of people who are living in U.S. nursing homes,1
20,673  —  Complaints of abuse, gross neglect, and exploitation on behalf of nursing home and “board and care” residents in 2003. 1 in 14  —  Number of incidents of elder abuse reported to authorities. 3

90%  —   Percentage of U.S. nursing homes with staffing levels too low to provide adequate care. 4
PROFIT MOTIVES AND CARE IN THE NURSING HOME INDUSTRY$75 billion  —   State and federal financing of nursing home industry in 2006. 5

$34 billion  —   Contribution of nursing home residents and their families in 2001. 6

$3.4 billion  —   Suspicious accounting transactions identified by U.S. News & World Report in 2000. 

31%  —  Extent to which deficiencies in care in for-profit nursing homes was higher than in non-profit nursing homes in 2006. 8

16%  —  Drop in nurse assistants’ hours per resident day. 

$1.2 million  —  Amount Veena Ahjua, operator of a 314-bed New York nursing home, paid herself in 2000. 10

1 million  —  2006 Salary of Genesis HealthCare Corporation CEO, George V. Hager, Jr. 11

$23,193  —  Median annual salary of a Certified Nurse Assistant 2008. 12

4.55  —  Recommended minimum hours of direct nursing care per resident per day. 13

3.7  —  Actual hours of direct nursing care per resident per day. 14


  1. National Center for Health Statistics  Health, United States, 2007, Table 117
  2. National Center on Elder Abuse
  3. Karl Pillemer and David Finkelhor (1988), The Prevalence of Elder Abuse: A Random Sample Survey, The Gerontologist, 28: 51-57.
  4. Correspondence from Senator Chuck Grassley and Representative Henry Waxman to Mr. Thomas Scully, (visited Feb. 3, 2005); citing U.S. Department of Health and Human Services (HHS), Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes, 2001.
  5. “At Many Homes, More Profit and Less Nursing” Charles Duhigg, New York Times, September 23, 2007.
  6. Id
  7. Id. In the article, a former fraud investigator said, “You never have anything show up as profit… They show these really skinny operating margins, so they can always plead poverty.”
  8. Centers for Medicare & Medicaid Services, Nursing Home Data Compendium 2007
  9. Christopher H. Schmitt, The New Math of Old Age, U.S. News & World Report, Sept. 30, 2002. quoting University of California researcher Charlene Harrington.
  10. Id
  11. Genesis HealthCare Proxy Statement
  12.  Certified Nursing Assistant – Nursing Home 2008 data                                                                                            swzl_compresult_national_HC07000412.html
  13. Charlene Harrington et al., Nursing Facilities, Staffing, Residents, and Facility Deficiencies, 1998 Through 2004, Department of Social and Behavioral Sciences, University of California, August, 2005, (visited Sept. 21, 2006).
  14. Id.

National Phone Lines Established for General Finance, Medical & Financial Abuse Advice

As of Nov. 10th, a  new national hotline for seniors and adult children of the elderly is available to deal with one of America’s biggest fraud problems: The estimated 1 out of every 5 citizens over the age of 65 who are victimized by a financial swindle/fraud. Of particular concern are seniors with mild cognitive impairment (MCI) who can perform most daily functions, but have trouble or become confused when it comes to managing their finances.! Elder phone line.jpg

In collaboration with the National Adult Protective Services Association (NAPSA), the Financial Planning Association (FPA), and Baylor College of Medicine, the Investor Protection Trust (IPT) and Investor Protection Institute (IPI) are making available three separate call-in lines – covering general finance, medical, and financial abuse questions — from 9:00 a.m. to 6:00 p.m. EST on Thursday, November 10, 2011. (See call-in details below.) Kiplinger’s Personal Finance is also a partner in the November 10th hotline project.

The toll-free hotlines will address questions and offer free advice in the following key areas:

General Finance Questions 888-227-1776. Callers are encouraged to dial into this number to speak with an expert from the Financial Planning Association about their family financial security. Callers will get answers to general financial questions, help identifying financial professionals that put your interests first and learn how to protect themselves and their loved ones from financial fraud. FPA professionals can also help initiate a conversation about money with adult children of older parents in order to help prevent elder investment fraud and financial exploitation.

Medical Questions 888-303-0430. Callers to this number can get advice from health care professionals about medical issues such as mild cognitive impairment that can impact an older person’s ability to make wise and safe financial decisions and can increase their vulnerability to elder financial abuse and exploitation. The health care professionals can help callers recognize the warning signs of vulnerability to financial abuse in themselves or loved ones and suggest referral routes for further medical screening.

Financial Abuse Questions 888-303-3297. Callers to this number will speak with an adult protective services (APS) professional about elder financial abuse and strategies for keeping themselves or older loved ones independent. Callers can get information on how to recognize the most common ways that older adults are financially exploited and methods for preventing elder financial abuse. APS professionals will also help callers take the proper steps if they suspect that a loved one is currently being financially abused or exploited.

About Kevin

Kevin Coluccio was recently named one of the Top 10 Super Lawyers in Washington State. He has long history of successful elder abuse/neglect cases and has a stellar reputation for getting results for his injury clients in serious car crashes, pedestrian accidents, trucking accidents, maritime claims, and asbestos injury cases.