Who Are Public Agency Investigators Protecting: The Neglected Elder Or The Perpetrator of The Neglect?
Wednesday, April 11, 2007, 06:56 PM - Assisted LivingAn elder named Mary Schneider died in San Francisco in May 2006. Two of her care givers went on trial this month on charges of criminally neglecting her, but the most shocking aspect of the case related to someone who wasn’t on trial, but should have been, the San Francisco Adult Protective Agency. That’s the public agency responsible for investigating complaints of elder abuse for elders who are not living in a long-term care facility. Mrs. Schneider, a 91 year old bedridden resident of a retirement hotel in San Francisco, “died in agony and neglect, suffering horrific bedsores” after APS failed to investigate her care, according to the San Francisco Chronicle.
Mary Schneider lived in one of San Francisco's most exclusive retirement hotels, and her son hired around-the-clock private care givers for her, but that still did not protect her from neglect. Her son, who was evidently unable to care for her due to his own medical condition of colon cancer, clearly thought his mother was in good hands with the care givers he had hired. But Adult Protective Services received a call alerting them that Mary was a suffering from bed sores, and weight loss, caused by possible neglect.
Adult Protective Services responded by sending social worker Andrea Glass to check in on Mary. Glass surveyed the room, and to all appearances Mary appeared to have "nice hair, nice nails, and a nice room." When Glass asked the care giver about the bed sores, the care giver responded, “I would never do anything like that.” The care giver’s denial was good enough for Andrea Glass, and off she went without looking at Mary’s body or following up with her doctor.
Mary herself was unable to speak on her own behalf and ask for Glass’s help.
In fact, Mary was suffering from extremely advanced bed sores, which apparently only were detected some 3 weeks later after her death. The care giver was criminally prosecuted, but the District Attorney, Elliot Beckelman, also reamed the Adult Protective Services investigator, telling the jury, “You know that’s outrageous, on a call for bedsores, not to look at the body. She was taken in by the visuals . . . That’s lazy.”
An investigation by the City of San Francisco found that APS had insufficient staff, inadequate training, and a failure to report suspected elder abuse, which Mayor Gavin Newsome has promised to rectify.
Adult Protective Services is not the only public agency that falls down on the job of protecting elders. The California Department of Health Services and Department of Social Services - the state agencies in charge of nursing homes and assisted living facilities – have investigators who often take the word of the nursing home or the rest home against the family or resident. Too often all it takes for the nursing home to get off the hook for neglect is for the nursing home administrator to simply deny it ever happened.
Can you or I get out of a traffic ticket simply by denying it ever happened? Can a bank robber walk away simply by telling the police officer he didn't do it? Why should it be any different for someone suspected of elder abuse?
The elder's family relies on the public agency to do their job -- often they don't, but no one realizes until it is too late. A lot of that has to do with the state investigators’ ridiculously heavy work load - that’s one less case that they have to follow-up on.
And, the nursing home, at the first hint of an investigation, hires teams of lawyers to inundate the state investigator with paperwork that is usually irrelevant to the charges. They would rather pay their lawyers than pay to correct staffing and budgeting shortages at the nursing home.
State investigators these days seldom take the time to interview care givers directly, and if they do, don’t ask tough questions that need to be asked.
To read the Chronicle article on Mary Schneider, click here.
Close Encounters of the Rodent Kind Demonstrate High Level of Neglect at Paragon Assisted Living Facility
Monday, April 9, 2007, 05:27 PM - Assisted LivingWhat does it take to get staff's attention at a bad rest home? The Associated Press reported last week that a lawsuit has been filed against an assisted living facility alleging that staffing was so inadequate “that a rat crawled into an Alzheimer’s patient’s mouth and died there before staff noticed.”
The lawsuit is filed on behalf of 90-year-old Alzheimer resident, Sigmund Bock, against Paragon Gardens Assisted Living and Memory Care Communities in Mission Viejo, California. The facility denied the allegations.
According to Steven Garcia, the lawyer representing Mr. Bock, records from the Paragon facility state that Mr. Bock was “playing with a rat in his room and eating candy with the rat.” Huh??
Paramedics called to the facility noted "possible ingestion of rat poison" in their report and an emergency room report says Mr. Bock was “found in room in care facility with dead rat in mouth.” Mr. Bock is now living in another assisted living facility where he is getting psychiatric treatment, presumably for his encounter with the rat.
Another lawsuit is pending against Paragon Gardens in connection with the disappearance of a 71 year old dementia patient, Troy Nelms, who wandered away from the facility and was never found. He is presumed dead. Department of Social Services has sued to revoke Paragon’s license, alleging that six clients were injured and one died after improper care there.
In other words, this assisted living facility has a horrible track record with the licensing authority, but it is likely that few of the residents or their families know about it.
The bizarre charting by the rest home staff member, "[resident] was eating candy with the rat" is a good example of how rest home staff are taught to make innocuous-sounding entries in the resident's chart, to attempt to normalize abnormal incidents and minimize the facility's responsibility for neglect.
Why Doesn't Department Of Social Services Put Meaningful Information About the Facilities It Licenses On the Web?
Thursday, March 22, 2007, 07:49 PM - Residential Care, Assisted Living, Cal. Dept of Social Services, Proposed LawsA colleague in our firm recently asked me if I could tell her how she could check the track record of a residential care facility that her father has moved to. The short answer is, “Realistically, you can't.”
California Residential care facilities for the elderly (RCFEs) are licensed by the California Department of Social Services Community Care Licensing Division, Senior Care Program Offices (“DSS” for short). As part of its oversight responsibilities, DSS investigates complaints made on behalf of residents, conducts surprise inspections, generates reports, and issues citations and fines to facilities who are caught violating the licensing regulations. DSS investigates so infrequently, and sometimes so ineffectively, that many bad facilities dodge the bullet and have a clean licensing file. So if DSS has actually cited or fined a facility, or found the facility to be in violation of regulations relating to resident’s rights or resident’s care, that is something you should know about before your loved one goes to live there. Department of Social Services does not post any of this vital information on the web. The only information they post is name, license number, and number of beds. To see their website,
This is a typical entry from the DSS website, for a RCFE in Albany:
Facility No: 015600285 Capacity: 0013
License Status: Licensed
RN3 LOVING CARE HOME
906 CORNELL AVENUE
ALBANY , CA 94706
Contact: CHENG, FANGJUAN
DO: CENTRAL COAST SC/RES (14)
DO Phone: (650) 266-8800
I have no personal information about the RN3 Loving Care Home, and the point is that neither will you, just by looking at the DSS website. But you should. The only way to access the DSS information now is to go to one of the 5 DSS Senior Care Program Offices around the State (Rohnert Park, San Bruno, Woodland Hills, San Diego, and Sacramento). That’s not reasonable access to this vital public information.
Posting of citations, fines, and evaluation reports for each facility would alert unsuspecting family members about that facility, and could actually force a change for the better in how these facilities care for their residents. The New York Times recently had an article about a new website put up by the U.S. Department of Health and Human Services
The website says that it “provides information on how well the hospitals in cities across the country care for all their adult patients with certain medical conditions, on a comparative basis.” The New York Times article described how in the year preceding the launching of this website, several prominent hospitals actually improved their performance in key aspects of their patient care for the reason that the hospitals knew that their ”score cards” would soon be on the web for all to see. The hospitals were candid in admitting that the prospective posting of the data on the website actually spurred them to improve performance.
RCFEs, like the hospitals listed on the www.hospitalcompare.hhs.gov website, would very likely do a better job for their elderly residents if they knew their track record would be there on the web for all to see. There is no excuse for hiding this information from California residents and their families.
Contact Ben Partington, Program Administrator at the DSS Sacramento Office, 744 P Street, MS 10-90 Sacrament, CA 95814, fax (916) 653-9335 and Governor Schwarzenegger (click here) and let them know what you think.
In San Francisco, a modern day Rosa Parks, Sally Herriot, has also refused to move. Sally is fighting for the right to live in her own home. Sally Herriot, an 88-year-old widow, lives in a spacious one bedroom apartment in Palo Alto, which she has called home for 15 years. Her apartment is part of a continuing care community called Channing House. Channing House has decided that it is time for her to go. They want to kick her out of her apartment and put her in a room that is essentially a hospital bed, saying that she is too old and feeble to live in her own apartment. Sally employs two care givers who help her on a 24/7 basis. They give her all the help she thinks she needs, thank you very much. She is fighting back. She told the San Francisco Chronicle:
“I’m a fighter... I’m sure they think I should shut up... I’ll put something in their way every time they move.”
The article says that Channing House stands to make a huge profit if they can force her out. She and her husband paid a nonrefundable $180,000 entrance fee to move to Channing House, and if she were to vacate the apartment, they could sell it all over again to the highest bidder. Sally’s husband moved to the assisted living part of Channing House, after he broke his pelvis in 2003. He only lasted 18 months after the move.
You can read more about Sally in the Chronicle article: sfgate.com
"I’M AS MAD AS HELL AND I’M NOT GOING TO TAKE THIS ANY MORE!"