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Abuse of Elderly in Nursing Homes and Assisted Living Facilities in California

A large number of California’s growing population of older adults reside in nursing homes and assisted living facilities. Nationwide, the Centers for Disease Control (CDC) reports that there are more than 818,000 people living in over 30,000 assisted living facilities. In addition, the CDC says that about 15,600 U.S. nursing homes house 1.3 million adults.

According to the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) there are 5,900 assisted living centers in California. And the California Association of Health Facilities (CAHF) says that around 1,230 licensed nursing homes care for 400,000 California residents each year.

Although most elderly residents receive adequate care in nursing homes and assisted living facilities, elder abuse is all too common. We’ve reported that one in 10 people aged 65 and older experiences abuse, but that statistic is most likely an underestimation of the actual incidence of abuse. The attorneys at Chain | Cohn | Clark hope to build awareness of elder abuse and encourage community involvement in preventing the mistreatment of this vulnerable population.

What Is Elder Abuse?

Elder abuse is mistreatment of someone 65 years old or older that causes harm. The mistreatment may be intentional or arise through negligence—that is, through a caregiver’s failure to provide care that meets the generally accepted standard.

The main categories of elder abuse are:

  • Physical abuse: For example, assault, use of physical restraints, or use of medications for restraint. Signs of physical abuse include unexplained bruises, burns, broken bones, or other injuries.
  • Sexual abuse: For example, rape, sexual assault, or any unwanted sexual touching. Signs include bruising or bleeding in the genital areas and fear or withdrawal in the presence of one or more specific individuals.
  • Emotional abuse: For example, threats, intimidation, and verbal abuse (e.g., name calling and insults). Signs of emotional abuse include agitation, withdrawal, changes in behavior or personal habits, depression, and anxiety.
  • Neglect: Failing to provide needed assistance, food, drink, medical care, or medication. Signs of neglect include bedsores, poor personal hygiene, malnutrition, dehydration, and unclean living conditions.
  • Isolation: Preventing an elder from receiving mail or phone calls or from seeing visitors. Signs include being repeatedly unable to contact or visit a loved one.
  • Financial abuse: Taking or improperly using an elder’s property or funds. Signs include sudden inability to pay bills, unexplained expenses or withdrawals, or the sudden disappearance of valuables.

What’s the Difference Between a Nursing Home and an Assisted Living Facility?

Nursing homes and assisted living facilities provide different levels of long-term care for their residents.

  • Nursing homes, or skilled nursing facilities, provide 24-hour nursing care in a standalone facility or as part of a hospital. They must have physicians and nurses and other support personnel on staff. In addition to housing and meals, they provide medical and nursing care, dietary and pharmaceutical services, rehabilitation services for residents recovering from injuries or medical procedures, and recreational or social activities.
  • Intermediate care facilities are a subcategory of nursing homes. They offer an intermediate level of care between a nursing home and assisted living.
  • Assisted living or residential care facilities for the elderly (RCFEs) are not required to include doctors or nurses on staff. They provide care for elders who can’t live independently but don’t need round-the-clock nursing care. They offer housing and meals, cleaning and laundry services, help with personal hygiene and daily tasks, transportation, and activities.
  • Continuing care retirement communities (CCRCs) are a hybrid type of long-term care facility. Typically, residents pay a substantial fee for entrance into the community. The CCRC provides independent living, assisted living, and nursing home care all in one location. Individuals progress from independent living to other modes of care as needed.

Nursing homes and CCRCs that offer 24-hour nursing care are considered healthcare facilities. They are licensed under the California Department of Public Health (DPH). Assisted living facilities are not considered healthcare facilities. They are licensed under the California Department of Social Services. This distinction is important when it’s necessary to file a complaint against a nursing home or assisted living facility.

What to Do When You Suspect Elder Abuse in a Nursing Home or Assisted Living Facility

If you suspect elder abuse—especially if you’ve observed any of the warning signs covered above—it’s important to take prompt and appropriate action.

Examples of Abuse and Neglect in Nursing Homes

Unfortunately, it’s not hard to find examples of abuse of the elderly in nursing homes. In a 2021 case in Riverside County, a nurse was charged with criminal neglect after a 69-year-old woman’s unattended bedsore developed into gangrene and sepsis and caused her death.

Examples of Abuse in Assisted Living Facilities

Sadly, it’s not hard to find examples of assisted living abuse, either. The owners of a Los Angeles assisted living facility were recently charged with felony elder abuse after 13 residents died from Covid-19.

Steps to Take When You Suspect Elder Abuse

First, if someone is in immediate danger, call 911.

If the victim of the suspected abuse is not in immediate danger, here are the steps you can take in order of increasing urgency:

  • Contact the staff of the nursing home or assisted living facility and express your concerns. Many complaints can be resolved in this way.
  • Contact the local long-term care ombudsman. A long-term care ombudsman is a trained official who advocates for nursing home and assisted living residents.  They can initiate investigations of abuse in assisted living facilities or nursing homes. The statewide 24-hour ombudsman hotline is 800-231-4024. You can reach the Kern County office directly at 661-323-7884.
  • If you can’t resolve your complaint in either of these ways, you can go directly to the state agencies that oversee long-term care facilities.
    • For nursing home abuse cases, contact DPH. DPH must initiate an investigation into any nursing home abuse case within two days and should complete an investigation within 60 days.
    • For assisted living abuse cases, contact the Community Care Licensing (CCL) branch of the Department of Social Services. CCL must initiate an investigation of an assisted living abuse case within ten days.
  • If you’re not satisfied with the results of the DPH investigation in a nursing home neglect case or of the CCL investigation in an assisted living neglect case, you can contact your state representative or senator and request assistance.

At any point in this process, if you suspect a crime has been committed, you can make a report to the local police department or sheriff’s office.

In addition, consider consulting an elder abuse attorney. Long-term care facilities are likely to take things more seriously when there’s an active DPH or CCL investigation—and if they’re aware that you’ve retained legal counsel. DPH and CCL can impose citations and fines, and law enforcement can charge abusers with crimes. However, only with the help of a qualified lawyer can you pursue reimbursement for medical expenses your loved one may have incurred or compensation for their pain and suffering.

Experienced Elder Abuse Attorneys

The Bakersfield elder abuse lawyers of Chain | Cohn | Clark can help collect evidence to support your abuse claims and support you through the complicated process of unraveling an abusive situation. Contact us today for a free, no-obligation consultation about your elder abuse case.

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