California Elder Abuse Lawyer Blog

In the new year, patients, families and visitors to California skilled nursing facilities (aka nursing homes, convalescent care centers) will be able to read the federal ratings of the facility utilizing a 1-5 star system. These ratings must be publicly posted and are intended to reflect the quality of care provided by the facility. New requirements also go into effect that inform interested parties how to obtain information about a facility's record from the California state licensing agency - the Department of Public Health ("DPH"). While this system is imperfect in that it may not feature the most current information, it goes a long way to bring to the forefront of the public's consciousness that such surveys and results do exist, and then provides guidance on how to examine a facility's record in greater detail by contacting the DPH.

What seems to be missing from this process is that families need to be aware that the time to avail themselves of this information is prior to their loved one's admission to a skilled nursing facility, rather than during or after the admission process. Requesting a list from hospital discharge planners of all appropriate potential facilities prior to hospital discharge and then making on-site visits, including reviewing the rating system and contacting the DPH will now be critical steps in helping to choose the best possible facility for a loved one.

If a litigant received medical care paid for by Medicare and related to the injury claimed in a lawsuit, the litigant is required to pay Medicare back for those services if they prevail by settlement or jury award. So, the typical nursing home patient suing under the Elder Abuse Act for Neglect likely received medical care for injury related services. Consider, for example, the elderly victim who fell and was transferred to the hospital for hip surgery. Or the elderly nursing home resident who develops severe, infected bedsores and requires surgical debridement and IV antibiotics.

When a lawsuit is initiated under these circumstances, Medicare should be notified. However, the reporting requirements for claims involving liability insurance and the Medicare secondary payer system are murky, confusing, contradictory, poorly understood, and fraught with all the qualities of an ever-moving target.

Recently, The Department of Health and Human Services, Center for Medicare and Medicaid Services and Medicare Secondary Payer Recovery Contractor (MSPRC) mandated that defendants must report lawsuits, not just the plaintiff litigants and/or their counsel. However, MSPRC just announced a one-year moratorium on these reporting requirements. These requirements, due to have been implemented next month have been delayed until October 11, 2011. This moratorium means that defendants will not be required to report settlements that occurred prior to October 11, 2010. If one checks the MSPRC web site, no information is available as of today's date concerning this change.

Continue reading "California Nursing Home Settlements Subject To One-Year Moratorium on Medicare Secondary Payer Reporting Requirements" »

I previously reported on the unprecedented Skilled Healthcare verdict relating to chronic under-staffing in 22 nursing homes over a 6 year period. The jury awarded the members of the class $677,000,000, a figure derived by multiplying a $500 statutory penalty times the number of days each of the 22 facilities were proven to be staffed under the legal minimum multiplied by the number of residents in each home on those days. It was a staggering verdict, one that was hard fought by the attorneys who devoted 6 years to the litigation. Kudos to them for initiating a lawsuit and seeing it through to the end in order to really advance the cause of elderly nursing home residents.

Importantly, in addition to the jury's monetary award, the court also issued an injunction, a court order requiring the Skilled Healthcare company to properly staff their nursing homes according in order to meet the needs of all of the residents they serve. This type of injunction is also unprecedented; it provides for oversight and penalties over the next two years to ensure the corporation follows the law . It will reportedly cost the corporation over $12,000,000 to institute this program.

This verdict, of course, not only affects Skilled Healthcare, but the entire nursing home industry (at least in California, which has the special provision regarding daily statutory penalties for understaffing). It sends the message to nursing home chains that they may pay a huge penalty if they continue to cut corners on staffing to boost profits. Gone are the days of thinking either they won't get caught understaffing or if they do get caught, the penalty ($500) is inconsequential.

Continue reading "California Understaffing Lawsuit Settled for $62.8 Million dollars." »