April 25, 2017, The San Diego Union-Tribune - Elmcroft of La Mesa, an assisted-living facility, has been put on probation for three years — but has avoided being shut down after regulators had threatened to do so.
The probation comes after the state put 48 assisted-living centers on probation and closed 46 for a range of infractions last year, according to Michael Weston, a spokesman for the California Department of Social Services. More of these disciplinary actions have occurred in 2017.
The agency licenses such facilities.
Elmcroft of La Mesa came under scrutiny after a string of fights between its residents, who suffer from dementia. Those altercations occurred in 2015, including one that ended in the death of a 92-year-old woman who was found in her room with blood-filled contusions on her head. The injuries were apparently inflicted by her neighbor, a man found in an adjacent room “naked and crawling on the floor yelling, ‘Get the hell out.’”
State investigators later found, in a petition to revoke the facility’s operating license, that Elmcroft of La Mesa’s staffing levels were too low to ensure that residents with memory loss — who can be easily agitated by their mental condition — did not come into conflict with each other.
The hearing on whether Elmcroft of La Mesa would lose its operating license was originally scheduled for Aug. 29. Records show the session was delayed twice before an administrative law judge at the state Office of Administrative Hearings heard the case in mid-February.
Elmcroft Senior Living, the Kentucky-based company that operates 83 senior living communities in 18 states, agreed to a probation program that took effect in late March for its La Mesa location. The deal specifies that state inspectors can conduct unannounced compliance visits and that Elmcroft La Mesa’s staff would undergo two hours of additional training on dementia patients’ tendency to wander off.
The facility is required to verbally report any “unusual incident” on the first weekday after each occurrence, and in writing within seven days.
The probation agreement also calls for a “qualified skilled professional” to conduct behavioral reviews of all the facility’s residents and to record their specific locations once per hour. Security cameras are now required in outdoor courtyards, and recordings of outdoor activities must be kept safe and available to inspectors for three years.
Ed Ward, a divisional vice president for Elmcroft, said in a statement: “We are pleased to have the support of (the) state in the resolution of this matter and look forward to continuing to serve our residents.”
Last year, the San Diego County District Attorney’s Office said it was investigating the death of the 92-year-old resident, Norma Desick.
In an update, the office said no charges were filed in the case. “We do not discuss our charging decisions, except to say we can only file charges when we believe we can prove them beyond a reasonable doubt,” said Tanya Sierra, a spokeswoman for the office.
Desick’s family filed a civil lawsuit against Elmcroft La Mesa alleging negligence, wrongful death and breach of contract. Natalie Holm, the attorney who represented the family, said the case has been resolved but didn’t elaborate.
Meanwhile, Holm and several other attorneys have represented other former residents of Elmcroft La Mesa in lawsuits against the facility, alleging various types of deficient care.
After looking at the probation agreement, Mary Ball, chief executive of the nonprofit group Alzheimer’s San Diego, said she felt a bit conflicted.
She noted that some of the its requirements, such as the mandates for more training and unannounced inspections, are positive but not necessarily punishment against Elmcroft La Mesa. Those policies will be required of all residential care facilities for the elderly starting on July 1, due to changes in state law.
Ball said in the end, it’s important to strike a balance between providing critically needed services for the elderly and making sure that people with Alzheimer’s disease or related dementias don’t hurt each other when they become confused or frightened while living close together.
“There is a great need out there for memory care facilities, but we need them to be good and high-quality. I’m hopeful that meaningful changes have taken place at Elmcroft of La Mesa, but only time will tell. The accountability for the tragic incidents that happened at this facility really lies with the staff and the larger organization for not providing the necessary oversight,” Ball said.
Facility inspection reports posted on the state’s enforcement web site indicate that Elmcroft of La Mesa had an incident on Feb. 7 where a caregiver put a hand over the mouth of a resident who was yelling while being bathed. The incident was reported by a fellow staffer who “heard a muffling sound and the resident stopped yelling for a moment.”
According to the report, the staffer who reportedly put his hand over the resident’s mouth was “terminated from the facility.”
People who want to check a state-licensed assisted living home’s performance record can visit bit.ly/CAassistedliving. Select “assisted living” from the long list of facility types on the site’s search page and then enter the desired facility’s name, address or license number.