Wrongful Death in Extended Care Facilities

When long-term care was needed for her mother, Carmen Shannon researched and visited many extended care facilities near her home in West Covina, California.

Finally, Shannon thought she had made the right choice. She had questioned nutritionists and dieticians, diligently checked records of inner actions (such as ambulatory patient's hospital visits) and thoroughly inspected the premises, right down to fire extinguisher availability.

"To no avail," she says.

"My Mom was on dialysis and was very weak; she couldn't stand up for long - she fell a few times and constantly burnt her food," says Shannon. "I worked at 911 dispatch and after my shift I would go to her home, feed her and take her to appointments. She lived by herself and it was difficult getting a home worker in." It was Shannon's intention to place her mother in a care facility until she could regain her strength. "My Mom felt guilty and said she was a burden. Even though she got weaker, she was sharp as a tack: her mind was willing but her body wasn't able..."

Shannon and her sister decided on [this] nursing home because "The staff said they could handle my mother as they had training with diabetic patients. They said that they had a physical therapy program and focused on getting people back to a level of independence," says Shannon. "They lied."

Just 72 hours later, her mother went into a diabetic coma.

Shannon and her 32-year-old son admitted her mother and spent a few hours talking with the administrator. "She was given a quick physical examination and we stayed until visiting hours were over," she says. "The next day I came back with my husband. She was frustrated - she didn't have all her things so I decorated the room to make her more comfortable and we set up her TV.

"Her dinner was brought in - peas and carrots, macaroni and cheese, rice and bread on the side and orange juice - not a diabetic diet. My husband got her a burger. I talked to the nurse about her food and emphasized that she was diabetic. The main reason for her going in was so that she could eat on a consistent basis."

The next morning Shannon's brother-in-law visited and found her asleep, but snoring strangely. "He told the nurses she didn't sound right and they blew him off and said she was OK. He reiterated his concerns and left.

"I got a phone call that morning, saying that my mother was 'non-responsive' and they had called the paramedics. The nursing home was two blocks from the Pomona Valley Hospital. They were going to send her there right away. We sped to the hospital, a 40 minute drive, and got there before she did."

By the time Shannon's mother arrived at the hospital she was brain dead.

"She was in ER for most of the day and they finally moved her to a room where she was hooked up to IV, oxygen etc. but she wasn't there," says Shannon. "My mom made me promise that if anything ever happened to her, not to have her languish. The doctors said that if she did survive she would be a vegetable."

"A few physician assistants in ER told me that this should not have happened. They knew about the nursing home.

"It was unreal how insensitive the staff at the nursing home was. They wouldn't let me see her charts or any documents of her meals and medications. I saw her chart at the nurse's station and apart from her initial assessments and her intake, there was no documentation. She couldn't have been admitted without full medical records!

"I went to the dialysis clinic where she had gone for the past few years, to make sure they had given the records to the nursing home and indeed they had sent them. The nursing home said they didn't know she was diabetic.

Shannon talked to her mother's specialist and he advised her not to drop her inquiries. "I talked to the staff at the dialysis clinic and they were shattered and shocked; she had just been there the week before having tests," says Shannon.

"[The nursing home] needs to be held accountable. They sent us nothing. They had her Medicare information and the doctor at the nursing home even billed Medicare. For what? They didn't do anything for her," says Shannon.

Shannon's tragic story comes as no surprise to Barbara Becker. Her mother-in-law was placed in Extendicare and was killed by a patient who had been a violent criminal most of his life. The care facility told Becker that she had an injury and fell down.

It took a lot of digging and a lot of time to find out exactly what happened; Becker even hired a private detective. After a lengthy inquiry, the court determined that her mother-in-law's death was a homicide. She also found out that this violent patient had attacked others and if it were not for Becker, he would probably be injuring more patients to this day.

The Nursing home knew about this patient - they had records of his criminal past. "Taxpayers were paying for his care and this was all that Extendicare was concerned about," says Becker.

Since this tragedy, Becker, along with advocacy groups and many individuals, "Chip away at a mountain with a toothpick." She cites 30 years of government reports stating abuse in extended care facilities, and nine out of 10 extended care facilities are understaffed.

"A report including my case in 2001 says that one-third of the nation's elderly in homes were abused," says Becker. There are [public reports] repeatedly made to congress on the corrupt oversight system. "It has been revealed that nursing homes do not meet state and federal regulations," says Becker.

In 2000, [Beverly Enterprises] was found guilty of fraud - taking public funds and not providing care. According to Becker, "They are still doing this, even when they got caught with their hands in the till."

"We have sex offenders currently living in nursing homes and the law says that people just have to be notified. Patients in nursing homes run the gamut from starvation to abuse," says Becker.

Mainly because the biggest expense is staff, companies cut to the bone. The U.S. doesn't have any staffing legislation - yet. "The law says staff to patient ratio should be adequate to meet patients needs - how open-ended is that?" says Becker.

"Not much value is put on an older person's life at many extended care facilities," Becker discovered. Isn't it about time we look after our elderly?