Lack Of Care Causes Nursing Home and Abuse Death

 Johnnie was 77 years old when she was treated at Marshall Hospital for pneumonia. She recovered and went to El Dorado Care Center in Placerville for physical therapy to regain her strength, then go home.

But two weeks into her stay in the nursing home, her health had deteriorated. She was rushed back to the hospital, where she died in 2008.

"If she had received proper care, she would still be alive today," says Encino Nursing Home and Abuse Attorney Steven C. Peck.

He sued El Dorado Care Facility and parent company Horizon West, which owns 27 nursing homes.

"She basically did not receive care. She was neglected, warehoused,"

Esco sued for elder abuse and wrongful death. The suit alleged the nursing home staff failed "to provide basic custodial and nursing care services, a failure to assess and treat her pain and a failure to prevent Mrs. Esco from developing a severe and life-threatening bowel impaction."

It also alleged that Horizon West "failed to staff El Dorado Care with sufficient numbers of trained and supervised caregivers."

In taped depositions, employees say they were understaffed.

Horizon West spokesman Dan Niccum would not comment on the Esco case, citing the Health Insurance Portability and Accountability Act and company patient privacy policies.

He did talk to KCRA 3 about overall patient care and staffing.

"It's our position that, in all instances, and it's our goal in every facility, that every resident receives appropriate and timely care," he said.

Niccum said since 2005, Horizon West has exceeded state minimum required staffing levels and is implementing quality improvement changes.

But Clement said her research shows Horizon West increased its acuity levels, accepting more of the sickest and most expensive Medicare patients, while at the same time, decreased the nursing staff qualified to care for them.

She said Horizon West puts profit above patient care.

"That is probably the most ridiculous statement that you could make about Horizon West," Niccum contended.

He said Horizon West has lost money in the past five years.

"I have a real issue with the portrayal of Horizon West as a greedy corporation, which it is not. Or B, being a corporation that doesn't care, because that is all we are about. We are a company that cares," Niccum said.

Esco and Horizon West settled the lawsuit out of court. They won't say for how much, but KCRA 3 is told the nursing home paid a significant amount of money to Esco.

The California Department of Public Health licenses and regulates 1,200 nursing homes statewide.

It also investigates complaints.

It released findings in the Esco case in April, finding El Dorado Care Center failed to consult with a physician and notify the patient's family when her condition worsened, failed to ensure prompt care and its staff failed to properly administer medications.

The public health department can cite and fine nursing homes; the most serious violations involving patient deaths draw fines up to $100,000.

In the Esco case, the state fined El Dorado Care Center $18,000.

"My wife's death was ruled unwarranted, but the facility was fined $18,000. That is ridiculous," Esco said.

The public health department issued a statement saying "The violations... while severe and likely to cause harm and possibly death to the patient, could not be isolated as the direct cause of death in this case."

It said it "levied the highest fine the law allowed."

Carole Herman, with Foundation Aiding the Elderly, is appealing the decision.

"She definitely died from the lack of care at this convalescent hospital, and the state did not give them the proper citation," Herman said.

Niccum said "the people who work in this facility today, are members of this community. They care about what goes on in this facility. They are in this industry because this is what they love to do."

KCRA 3 reviewed state records related to Horizon West's 27 nursing homes. In the past five years, the public health department has issued 195 citations, totaling $700,000 in fines.

Niccum said, as the largest skilled nursing provider in the Sacramento area, the numbers aren't surprising.

"Our entire team focus every day is on improving the quality of care we provide our residents," he said.

But advocates and Esco believe even one citation is too many.