Rapid City, South Dakota Attorney, Mike Abourezk, handles cases involving cost-cutting incentive programs that nursing home companies use to reduce employees labor costs, which he says, predictably result in shoddy care. "When fewer, less well-trained staff members are forced to care for the same number of elderly residents," he explains, "their ability to do so becomes difficult."
However, he points out that the job gets easier if residents are given medication to make them sleep a lot because then they don't ask for much. "Noisy, demanding residents make it hard for these already struggling staff members," he says. "Medication helps tremendously."
State law enforcement agencies are finding ways to investigate nursing homes that provide substandard care and the inspection process that allows it to continue. On June 2, 2006, California Attorney General, Bill Lockyer, announced that the Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) had arrested the owner of 6 California nursing homes in connection with the bribery of a nursing home inspector from the LA County Department of Health Services (LADHS).
The BMFEA criminal probe began with its September 2005 "Operation Guardians" inspection of MZR's Huntington Healthcare Center in Los Angeles according to the press release. Established by Mr Lockyer, Operation Guardians is a task force that conducts surprise, on-site inspections of California's 1,400 skilled nursing facilities.
Operation Guardians inspectors called MZR's center "the worst they have seen in a skilled nursing facility," according to the September 2005 report by the inspection team. The more than 40 violations at the facility included:
Residents wearing filthy clothes, soiled with urine and feces; a resident with an open head wound left unattended; rodent droppings in the pantry where residents' food was stored and improperly exposed; pigeon droppings in the residents' dining room; medication improperly stored and administered; inadequate medical record-keeping; and highly irregular practices regarding use of residents' trust accounts.
Following their inspection, the BMFEA launched an investigation into possible criminal elder abuse, and the LADHS was called in to clean up the conditions at the nursing home and protect the residents.
LADHS then conducted its own inspection and the inspector asked Agulto about reports that MZR hired LADHS employees as "consultants" to perform work outside the scope of their government job and Agulto asked the inspector if he was interested in becoming a "consultant."
Shortly before Christmas in 2005, Agulto contacted the inspector and said Robertson wanted to give him a holiday card, and Agulto delivered the card with $500 inside on December 24, 2005.
According to the criminal complaint, the inspector then contacted the BMFEA and agreed to work as a confidential informant. The inspector subsequently met with Robertson, Agulto and Mercado at various times and was offered a job as a "consultant," according to the complaint.
While acting as an informant, the inspector received an additional $6,500 in bribes from January 2006 through April 4, 2006. In addition to the money, Robertson gave the informant an $800 Prada purse, and offered to provide him with paid vacations to Europe, as well as a Lexus or Mercedes.
In return for payments, the complaint says, the inspector was told to alert the defendants of any upcoming Health Department or the BMFEA inspections. Robertson and Agulto told the inspector not to worry about being caught because Robertson had other Health Department employees, including managers, on the payroll.
In his press release, Mr Lockyer said, "I hope the owner's claims of having a cadre of public employees secretly on her payroll prove to be false bravado."
"But if they are not," he warned, "we will apply the full force of the law."
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