Articles Posted in Nursing Home Abuse and Neglect

An investigation by The Oregonian has revealed that the state agency charged with fighting the abuse of senior citizens and the disabled has been hiding thousands of cases of neglect. The revelation calls into question Oregon’s entire approach to elder abuse and neglect and is a yet another reminder of the important watchdog role that both the media and our courts must always play in society.

According to the newspaper “the Department of Human Services operates a website that is supposed to help consumers identify safe havens for their aging loved ones, including those suffering from Alzheimer’s and other debilitating illnesses. But an investigation… found that officials have excluded nearly 8000 substantiated claims of substandard care from the state’s website.” The Oregonian reports that its investigation was based on examinations of state records that are not available online, and therefore harder for the general public to access and assess. It notes that “more than 60 percent of the substantiated complaints against care centers in Oregon since 2005 can’t be found on the state’s website.”

The Oregonian’s report emphasizes that all of the complaints excluded by the state and uncovered by this investigation had been verified by state employees. The question, in other words, was not whether the abuse occurred but whether Oregon was willing to acknowledge it.

Following up on a story I first wrote about last fall, a former nursing home assistant accused of repeated sexual assaults on his elderly patients will be going to jail for 25 years, according to The Oregonian. The newspaper reports that the man, who has been held in the Washington County jail since his arrest last September, pled guilty to two of the 28 sex crime charges against him.

The newspaper reports that the plea agreement is “global” – meaning that the defendant “won’t be indicted on the Multnomah County allegations” that have been made against him. After his initial arrest which focused on the alleged abuse of seven patients at Providence St. Vincent Medical Center five more people came forward with accounts of being abused by the same man while he was working at the West Hills Health and Rehabilitation Center in Portland between 2014 and 2016.

While it is satisfying to see some measure of justice done in this case, it has to be noted that the criminal plea agreement does not answer all of the serious legal issues this case raises. Under ORS 678.725 nursing home employees have a duty to report inappropriate conduct on the part of colleagues.

The sentencing this week of a former Kaiser Permanente nurse on charges of sexually abusing five women under his care should remind us all of the responsibilities hospitals, nursing homes, other care facilities and their staffs have toward their patients.

According to The Oregonian the 38-year-old man “pleaded guilty in Washington County Circuit Court to attempted second-degree kidnapping, second-degree invasion of personal privacy, third-degree sexual abuse and computer crime.” He was sentenced to two-and-a-half years in prison and will be required to register as a sex offender.

The newspaper notes, however, that in addition to the criminal phase of the trial, which is now over, two of the man’s victims “have since filed suit against Kaiser Permanente – where he worked for two years – alleging negligence by the medical company and sexual abuse and exploitation.” These charges are both significant and serious. Hospitals, nursing homes and other care facilities have an obligation to ensure that their staff are interacting with patients in a proper manner, and to report any suspected abuse immediately (see the Oregon Department of Justice and Oregon Department of Human Services links below for more information).

A story published this week in The Oregonian focuses on the suicide of a teenage boy who was living in a Corvallis residential treatment facility and on accusations that the facility falsified care records in an attempt to evade responsibility for its actions. There are broader issues also raised by the case, however, and I would like to take a few moments to examine both the issues raised by the newspaper and the ones that also merit our attention.

According to The Oregonian the boy, age 15, died last August. A state investigation showed that he was supposed to be closely monitored while in the facility, with staff checking on him every 15 minutes. Though the care center’s records indicated he had slept through the night, a state investigation showed that he had been left alone for 40 minutes at one point that evening despite having “told staff earlier in the evening that he was suicidal and had been bleeding from self-inflicted arm wounds.” The newspaper adds that the investigation turned up other instances in which “patients told regulators they also had gone without scheduled check-ins by the center’s employees.”

The focus of the newspaper story is on the alleged falsification of records and this is obviously a serious issue. If proper, legally required, records are not kept by caregivers and facilities it is impossible for patients to get the treatment they need and extremely difficult for cases of medical malpractice or nursing home abuse and neglect to be proven either while they are unfolding or after the fact. To be clear: this is an extremely important issue and one where it is critical to everyone’s health and well-being that federal, state and local regulators do their jobs.

At a moment when presidential politics have led to a national discussion about sexual assault last week’s news of a plea deal in an especially shocking case in Forest Grove was eye-catching. According to a report in The Oregonian the owner of a retirement home in that community received a two-day jail sentence and five years of probation after pleading “guilty in Washington County Court to 11 counts of third-degree sex abuse and one count of attempted third-degree sex abuse. More than two dozen other charges, including first-degree sex abuse, second-degree sex abuse, third-degree sex abuse and first-degree burglary were dropped as part of the plea deal.”

According to the newspaper the accused, a 73-year-old man, routinely groped women under his care and used his position as the home’s owner to press himself on his female employees. The victims ranged in age from their 30s to their 80s. The newspaper adds that the plea agreement was reached with the cooperation of the victims. “Nearly all the women said they wanted to avoid a trial, which would be a lengthy and humiliating process for them,” the newspaper notes, quoting a Washington County District Attorney’s Office spokesperson.

Two legal points stand out here, one shocking and the other offering some relief. The first is the negotiation of the charges down from first-degree sexual assault to third-degree. This is a significant difference. First-Degree sexual assault (ORS 163.427) is a Class B felony, meaning that each count could lead to up to ten years in prison and a $250,000 fine. Third-degree sexual abuse (ORS 163.415) is a Class A misdemeanor, which makes the maximum fine $6250 and the maximum jail time one year. Without wanting to second-guess a criminal prosecution decision that reportedly involved input from the victims, it has to be said that a mere two days in jail and, reportedly, no fine, seems like far less than prosecutors might have gone for, even under the reduced charges.

The announcement last week that the federal government will bar most nursing homes and other care facilities from forcing clients to sign care contracts requiring them to settle disputes in arbitration is an enormous victory for ordinary Americans – one that deserved more attention than it received in both the national and local media.

As the New York Times noted: “With its decision, the Centers for Medicare and Medicaid Services, an agency under (the Department of) Health and Human Services, has restored a fundamental right of millions of elderly Americans across the country: their day in court. It is the most significant overhaul of the agency’s rules governing federal funding of long-term health care facilities in more than two decades.” Because virtually every nursing home and care facility in the country receives funds from either Medicare or Medicaid (and often from both) the rule is, effectively, universal. The rule change was essential to curb the spread of arbitration since a 2015 Supreme Court ruling (DIRECTV v Imburgia) which not only held that arbitration clauses are legal but also threw out state-level bans on the practice.

Obviously a federal law banning forced arbitration clauses can’t be passed in Washington’s present polarized political climate, but with last week’s decision the federal government effectively used the leverage that comes from being the largest single player in our healthcare system to put citizens ahead of corporate profits. The new federal rules effectively overturn the Court ruling in the area of nursing homes and related services.

The decision by Portland police to charge a 34-year-old nursing assistant with the rape of an 87-year-old nursing home patient is drawing new attention to sexual assault issues in Oregon nursing homes, hospitals and other facilities that care for the elderly.

According to a recent article in The Oregonian, a Portland man “is charged with first-degree rape and first-degree unlawful sexual penetration. He… is being held in the Washington County jail with bail set at $250,000.” The paper adds that the alleged rape was not the first time the suspect had been brought to the attention of police: they received a complaint about him back in June in reference to the assault of a 94-year-old woman at the same facility “but couldn’t substantiate it at the time.” Now, the paper reports, quoting the Washington County Sheriff’s office, the accused could also face charges in that case. Law enforcement authorities tell the paper they believe other victims may also come forward.

The arrested man “was licensed as a certified nursing assistant in February 2015 and has no history of discipline. He graduated from the Caregiver Training Institute in October last year, according to records,” The Oregonian reports.

The Oregonian reports that a Beaverton nurse was allowed to continue working with patients while under investigation for sexual misconduct on the job and allegedly committed a similar offense during that time. The incident, if the facts are as reported, raises serious questions about how the nurse’s employer, Kaiser Permanente, deals with abuse allegations among its employees. The result is a case which concerns both hospital malpractice and sexual assault.

According to the newspaper the 37-year-old North Plains man was indicted earlier this month “on one count of first-degree criminal mistreatment, three counts of invasion of personal privacy, two counts of computer crime and four counts of third-degree sex abuse, police said. The charges relate to three alleged victims, but detectives have identified two more and are investigating their claims.”

The claim that the man was allowed to keep working is particularly striking when one considers how quickly the case has moved. Far from being something that has dragged on for many months or years, The Oregonian reports that “police first started investigating (the nurse) on Jan. 28 after a woman reported that he made sexual statements to her and sexually touched her during a visit to the Beaverton clinic two days earlier.” In other words, this case has gone from initial allegations to a wide-ranging indictment in about nine weeks – a case of the criminal justice system moving fairly quickly. Despite that, however, it is hard to imagine another workplace context where an employer would regard it as OK to keep an employee accused of sexual assault in a position to recommit the alleged offenses.

A California nursing home has been ordered to pay the largest fines allowed under state law following the death of a patient. For us here in Oregon this nursing home neglect and abuse case, though it comes from out-of-state, serves as a powerful reminder of the important role courts and regulators play in keeping watch over those charged with helping vulnerable seniors.

According to a report in the Orange County Register the case stems from the death of 93-year-old Donald Bodkin, who, the paper reports, “died in September from an undetected ruptured intestinal ulcer and infection.” Bodkin was not a long-time resident of the home but, rather, had checked in only a few weeks earlier for a temporary stay while recovering from hip surgery.

The paper reports that the state believes the home did not assess Bodkin’s condition properly, failed to tell his doctor once the symptoms became obvious and ignored warnings from both family members and an occupational therapist “that he was lethargic and in pain.” The nursing home has expressed regret for Bodkin’s death but said in a statement that it does not believe the actions of any of its staff “caused or contributed to this unfortunate event.”

A circuit court ruling issued at the end of last month has the potential to offer significant protections for Oregon families considering wrongful death claims related to Oregon nursing home abuse and neglect or medical malpractice.

The case, formally known as Bradley v Sebelius, turns on a wrongful death claim in Florida. After Charles Burke died in early 2005 his ten surviving children sued the nursing home where he had lived prior to his final hospitalization claiming that the nursing home’s negligence led to the infection that eventually killed their father. The case was settled out-of-court without reaching trial, with the nursing home’s insurer agreeing to a claim of $52,500 – the maximum that the home’s liability insurance policy would allow.

At that point, however, Medicare stepped in demanding that around half of the total settlement be remitted to the government to reimburse Medicare’s expenditures for Burke’s hospital care prior to his death. A probate court ruled against Medicare, deciding that it was entitled only to a share of the wrongful death settlement and awarding the government $787.50. Medicare took the case to federal court and won at the district level. That decision has now been reversed by the 11th Circuit Court of Appeals.