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Residential care facilities, nursing homes facing renewed calls for reform

El Chicano Weekly - 8/29/2014

Former San Bernardino County Deputy Coroner Monika Padilla once said she was interested in trying to do what she could to research concerns about local nursing home abuse. Padilla said she was willing to conduct more autopsies on those who might have died due to questionable circumstances. That was 20 years ago and Padilla was voted out of office shortly after.

Further back, the Associated Press reported during Gov. Jerry Brown's first term as governor, that citizen groups were asking him to form a task force to investigate nursing home and residential home conditions. In 1975, the Public Interest Law Center wanted Gov. Brown to look at the profits of nursing homes before allowing the state to allocate them any more money.

In 2014, there are currently 16 proposed state measures that could further regulate community care facilities. State Assemblywomen Cheryl Brown (San Bernardino) has authored AB 1899 which would put a lifetime ban on operator's who abandon their assisted living facility. Brown is a member of the Assembly's Aging and Long Term Care Committee. In a email response, Brown wrote that she has voted in favor of other legislation that would protect those residing in residential care facilities for the elderly (RCFEs).

Assemblywomen Brown relayed graphic reports of sexual assaults, severe injuries and at least 28 deaths occurring in RCFE's in San Diego County. Over the years, Brown said she has been an inhome care provider for several family members. She points out that RCFE's are commonly called assisted living and board and care facilities, ranging in size from six beds to a more formal setting of 100 beds. Brown said full-scale skilled nursing homes are licensed differently than RCFEs.

Brown went on to explain that health care facilities in California are regulated by a number of private and public agencies at the federal and state level, who sometimes have overlapping jurisdictions. She cited a 2013 report that showed the state department of social services, community care licensing division, ignoring numerous allegations of questionable deaths occurring in RCFE's.

Current statistics about long term community health facilities in San Bernardino are hard to find, however the stories are notorious. Well before the recent series of articles about health care abuse published by the San Diego Union-Tribune, the San Bernardino Sun published an investigative series by Mark Muckenfuss about the shortcomings of nursing homes. Muckenfuss wrote his articles in the mid1990's about the same time that Monika Padilla was coroner.

In 1954, Parade magazine's investigation about nursing homes showed that many patient's were dying from fires due to outdated structures. Others were injured from falling. Parade wrote of patient's lying in beds soaked in urine and the smell that went with it. They found that nursing home operator's took measures to keep patient's sedated "because it's easier that way." In 1954, Parade showed local police making arrests of those abusing nursing home patient's.

Today, the threat of fires at healthcare facilities is minimal. The stench of urine now comes from foley bags dangling from the side of hospital beds. Patient's now seldom lay in urine since nearly everyone is fitted with a catheter. Local police now seldom investigate such abuse. Other than that, some of the same negative descriptions remain from 1954.

"It's like the wild west," said attorney Randy Walton. "Whether it happens in a nursing home or residential care facility, neglect is still neglect." Walton has handled about 100 nursing home abuse cases in the past 15 years, with 12 heard in San Bernardino County. His typical case is a fall that could have been prevented. "After falling, the patient doesn't always get the proper attention. A fracture turns into an infection and the patient can die," says Walton, who is based in San Diego.

Walton said that nursing home officials act under the jurisdiction of an attending physician. Walton agreed that it's easier to care for a bedridden patient but "chemical restraint" is a major offense. He says that more inspectors are desperately needed to provide more oversight of community health care facilities. "I don't think there's been that much improvement of community care facilities. But in the last 10 years, there are more people watching. I think their conscience has been shocked. People are starting to pay attention. I haven't seen that before."

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