All they got was a slap on the hand.’ Is California low-balling penalties in nursing home death investigations?

Armando Reagan was 30 when he bled to death, rushed from a Southern California nursing home as blood soaked his sheets, pooled on the floor and as he pleaded with staff: “Help! Help! I do not want to die!” according to state public health records.

Paralyzed 11 years earlier in a drive-by shooting, Reagan, who was taking blood thinners, died later that day at a nearby hospital, where the emergency room documented profuse bleeding from bedsores in his groin.

Marleen Aparicio, a relative, assumed that the nursing home – Verdugo Valley Skilled Nursing & Wellness Centre in suburban Los Angeles – would receive the maximum punishment from the state: a Type AA citation and $100,000 fine, a penalty reserved by the California Department of Public Health for the most egregious deaths of nursing home residents.

Aparicio was mistaken. Instead, the department issued the facility a milder A citation and $20,000 fine over Reagan’s death in July 2010, concluding that nursing home staff did not adequately monitor the young man for adverse drug reactions.

“To know he was crying out like that,” said Aparicio, 61, a second cousin of Reagan, who had always called her “auntie.” “All they got was a slap on the hand: ‘Don’t do it again.’

“They made a mistake and, oops, that’s it?” she asked. “This is a mistake we know about. What about all the ones we don’t?”

Controversy over how the state penalizes facilities over suspicious patient deaths has been simmering for years, with elder-care advocates pushing for tougher oversight and harsher fines. The nursing home industry, meanwhile, has maintained that inspectors for the Department of Public Health have been uneven in their approaches, depending on which district office is in charge of an investigation.  (Click to Continue)

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All they got was a slap on the hand.’ Is California low-balling penalties in nursing home death investigations?