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Ash_F

(5,861 posts)
Thu Oct 31, 2013, 10:38 PM Oct 2013

Castro Valley: Janitor saw elderly become weak

Source: Carolyn Jones of the San Francisco Chronicle

Miguel Alvarez had never worked in a senior care home. He had never administered medications. The only reason he took the janitor job at Valley Springs Manor in early October was to save money for Christmas gifts for his kids.

Yet last week, as the Castro Valley care home plunged into chaos amid a state-ordered closure, Alvarez found himself changing diapers, bathing, spoon-feeding and otherwise comforting more than a dozen seniors who had been abandoned there.

"I'm a janitor - I didn't know what I was doing. I just tried the best I could," Alvarez, 33, said Thursday at his home in San Leandro.

Alvarez was one of two employees of the care home who stayed when everyone else - including management - left as the state yanked the operating license. On Thursday, he told his story to media members for the first time.

Read more: http://www.sfgate.com/news/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php



These men are heroes.
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Castro Valley: Janitor saw elderly become weak (Original Post) Ash_F Oct 2013 OP
Talk about tearing your heart right out of your chest madokie Oct 2013 #1
This has nothing to do with RepubliCONs. truedelphi Nov 2013 #40
There are truly good people in the world dem in texas Oct 2013 #2
True... awoke_in_2003 Nov 2013 #5
I hope he gets a hero's welcome and double pay or even triple pay plus a nice bonus. Auntie Bush Oct 2013 #3
This is what happens when you privatize Nursing Homes... ReRe Oct 2013 #4
Yes indeed -- and should be a warning to everyone Blue Owl Nov 2013 #27
Don't tell me we live in a functional society . . . Brigid Nov 2013 #6
I just want the tea partiers, immigrant haters, and xenophobes to take note of this guys name. Miranda4peace Nov 2013 #7
K&R DeSwiss Nov 2013 #8
absolutely! state should have followed up hopemountain Nov 2013 #39
Universal Health Care; socialized medicine ends this shit forever. Half-Century Man Nov 2013 #9
Socialism has failed everywhere it has been tried. Enthusiast Nov 2013 #11
Ha! You almost got me. n/t bitchkitty Nov 2013 #35
this makes me think of the tv show Derek Voice for Peace Nov 2013 #10
There is something wrong with this story. happyslug Nov 2013 #12
Of course the legal obligation would fall on the janitor Fumesucker Nov 2013 #13
Yep, life in the new banana republic. truedelphi Nov 2013 #41
I will avoid merely expressing disgust at you calling him a criminal... Ash_F Nov 2013 #14
Agree with almost everything you say, but I think the state needs to send in truedelphi Nov 2013 #42
He said he made several 911 calls, but only after October 25, 2013 happyslug Nov 2013 #45
So, using your logic, if I see a child get hurt outside LeftofObama Nov 2013 #15
That is the law in most states, in fact you do not even have to call 911. happyslug Nov 2013 #46
great stuff to know! Thanks! BlancheSplanchnik Nov 2013 #54
you can tell us how long you think he should be in jail to make the world a better place CreekDog Nov 2013 #16
Actually no jail time for the Janitor, but someone should spend some time in jail happyslug Nov 2013 #50
More on the story, with differant source links, enjoy the read! Rebellious Republican Nov 2013 #17
State Inspectors were in the home on the 24th AND the 25th??? happyslug Nov 2013 #48
Well, the second half of your user name seems to be correct. ret5hd Nov 2013 #18
I shall keep your response in mind the next time I am in a good samaritian Katashi_itto Nov 2013 #19
From what has been reported, 911 was called multiple times. LisaL Nov 2013 #20
I didn't blame him, I just pointed what he did was a technical crime. happyslug Nov 2013 #49
... Javaman Nov 2013 #22
Your empathy meter is broken ConcernedCanuk Nov 2013 #23
he did GREAT!!! noiretextatique Nov 2013 #33
Message hidden by jury decision. L0oniX Nov 2013 #24
Send it to a jury. I predict it will be allowed to stand Gormy Cuss Nov 2013 #26
This message was self-deleted by its author Gormy Cuss Nov 2013 #25
Good Samaritan rules should apply here. colorado_ufo Nov 2013 #28
what you said .. . . . n/t annabanana Nov 2013 #44
no, the management and staff who left put them at risk noiretextatique Nov 2013 #32
By Federal Law that is what suppose to have been done happyslug Nov 2013 #57
This is one of the most ridiculous things I've ever read. Disgusting. pothos Nov 2013 #34
He called them four times. happyslug Nov 2013 #59
You're unbelievable. n/t bitchkitty Nov 2013 #36
I deal with nursing homes all the time. happyslug Nov 2013 #58
duh, something is wrong here, this whole facility was bad news and the state wasn't on top wordpix Nov 2013 #66
Illustrate the strength of your convictions and call the cops if you think he's a criminal... LanternWaste Nov 2013 #38
He falls into the category of a bystander who assists Yo_Mama Nov 2013 #47
That is NOT the Common Law Rule happyslug Nov 2013 #51
It's true that you do not have a duty to call Yo_Mama Nov 2013 #55
the employee had a duty to take care of these people until relieved of that duty passiveporcupine Nov 2013 #56
Under the common once he starts to help someone he can not stop. happyslug Nov 2013 #60
Please direct me to that law passiveporcupine Nov 2013 #63
First it is case law. the Wikipedia cite does a nice overview happyslug Nov 2013 #68
under voluntary assumption of duty to provide care: passiveporcupine Nov 2013 #69
Not my take in the rule happyslug Nov 2013 #70
Miguel Alvarez is a hero. polly7 Nov 2013 #21
He certainly is. Brigid Nov 2013 #30
I don't understand it either. polly7 Nov 2013 #31
Yes he is a hero. n/t truedelphi Nov 2013 #43
Do your part to help neffernin Nov 2013 #29
Sad Nick Junior Nov 2013 #37
Any licensed medical professional (CNA, RN, LVN, etc.) who walked out of that facility Mr.Bill Nov 2013 #52
My suspicions is they have NOT had a RN in months, if ever happyslug Nov 2013 #61
I think you are correct. Mr.Bill Nov 2013 #62
you may be right in your guesses BUT I just spoke to staff at a facility about this wordpix Nov 2013 #67
Speaking as someone with an elderly parent in a facility AnnieBW Nov 2013 #53
another thing the private sector does better than yurbud Nov 2013 #64
as the daughter of an advanced Alzheimer's patient, I'm aghast wordpix Nov 2013 #65

madokie

(51,076 posts)
1. Talk about tearing your heart right out of your chest
Thu Oct 31, 2013, 10:53 PM
Oct 2013

this does.

Damn the republiCONs, every one of them. damn them to hell.

truedelphi

(32,324 posts)
40. This has nothing to do with RepubliCONs.
Fri Nov 1, 2013, 05:40 PM
Nov 2013

It has to do with the fact that here in Calif., there are 37 million people.

And so when you have total EVIL DOERS, such as the owners of this facility - who had already had one elder care operation of theirs closed by the state - the state can't connect all the dots and figure out that these people have another operation going on elsewhere.

I am of the belief that the only way things will work in California is if the state gets divided up into four or five separate states. Even dividing the state into two would leave each state with close to twenty million people.

dem in texas

(2,673 posts)
2. There are truly good people in the world
Thu Oct 31, 2013, 11:05 PM
Oct 2013

What a great thing he did! He could have walked away like the other employees, but he and the other person knew that had to do the right thing. They chose to stay and care for those helpless people. They deserve a community award for their actions. I hope the families of the elderly people who were left there sue the pants off the nursing home operator and state throws their asses in jail.

ReRe

(10,597 posts)
4. This is what happens when you privatize Nursing Homes...
Thu Oct 31, 2013, 11:41 PM
Oct 2013

... it's what happens when you privatize anything associated with the medical field. Lives and quality of care don't matter, only the bottom line of the Corporate overlord. Well, his ass is grass now. Both the manager and owner should be sitting in deep doo-doo inside a jail cell within the county of that Nursing Home today. And looks to me like the State is just as guilty. Total negation of duty, all the way around. Why didn't the nurses themselves call the local or state police or nearest hospital before they walked out of the building? I guess the two fellows didn't know what to do and thought someone was surely coming, so they would do their best until they came. The next morning, I would have been on the horn blowing the whistle sky-high.

Blue Owl

(50,226 posts)
27. Yes indeed -- and should be a warning to everyone
Fri Nov 1, 2013, 12:27 PM
Nov 2013

Everyone with a functioning brain, at least...

Miranda4peace

(225 posts)
7. I just want the tea partiers, immigrant haters, and xenophobes to take note of this guys name.
Fri Nov 1, 2013, 12:26 AM
Nov 2013
Miguel Alvarez The article doesn't mention his status, and he very well could have been a citizen all his life, but I think it's safe to assume that those residents would have been a lot worse off if Miguel, or his previous relatives hadn't immigrated to the United States.

Now this my friends is a real Christian!

By late Friday, he noticed some of the residents felt "clammy" and had trouble sitting up. He said he and Rowland called 911 several times when residents appeared to be sick, and finally sheriff's deputies and firefighters arrived Saturday afternoon to rescue the remaining residents.

"I just thought, thank God, now they'll be safe," he said. "I just went home and slept."

On Wednesday, Alvarez and Rowland - worried about Bascom, whom they say called himself "Goldfinger," - got together and rode their bicycles around San Leandro looking for the friendly, mentally ill man.

"If we can find Goldfinger, then we'd really be heroes," Alvarez said. "I just feel bad for what happened, though. I wish we could have done more."http://www.sfgate.com/news/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php

hopemountain

(3,919 posts)
39. absolutely! state should have followed up
Fri Nov 1, 2013, 04:50 PM
Nov 2013

or notified county healthcare. terrible situation. those poor folks in the home!

Half-Century Man

(5,279 posts)
9. Universal Health Care; socialized medicine ends this shit forever.
Fri Nov 1, 2013, 12:41 AM
Nov 2013

Each and every owner and management person in this organization should serve at least 1 year in prison, and lose their rights of citizenship.

Enthusiast

(50,983 posts)
11. Socialism has failed everywhere it has been tried.
Fri Nov 1, 2013, 01:45 AM
Nov 2013

I kid. I thought I would repeat the standard rightie® talking point.

 

happyslug

(14,779 posts)
12. There is something wrong with this story.
Fri Nov 1, 2013, 02:28 AM
Nov 2013

The license was suspended effective Thursday October 24, 2013. he called 911 on Friday October 25, 2013. No date is given when the staff or manager left.

At the time the license was suspended, the state agency that suspended the license should have checked into the condition of the patients.

If the license was suspended on the 24th, that is the date this man should have called 911, for he was unqualified to do any of the work and thus he should have called 911 once he determined he and one other person were left with these patients. He should NOT have given then their medications (he is NOT a nurse AND does not have the records of who gets what), instead he should have called his employer and when he received no response 911.

He admits to giving out medication, that by itself is a violation of the law, he has no knowledge who received what and thus it was illegal for him to disperse any medication. Instead he should have call 911 once the staff left. I suspect 911 had been called (By the unpaid staff as they left), but I also suspect he or his fellow worker told 911 when they called back everything was fine (hoping for someone to come back, when everyone had left).

Sorry, by NOT calling 911 on the 24th, he and his co-worker who stayed put these patients at risk, which again is a criminal act on his part. He should have called 911 when he first notice the nursing staff was gone. That is what he was legally obligated to do and failed to do till the 25th,

Fumesucker

(45,851 posts)
13. Of course the legal obligation would fall on the janitor
Fri Nov 1, 2013, 02:50 AM
Nov 2013

Certainly not on management or on the staff actually trained to do the job.

truedelphi

(32,324 posts)
41. Yep, life in the new banana republic.
Fri Nov 1, 2013, 05:41 PM
Nov 2013

Where any and every good deed is to be severely punished, while the bad guys get away.

Ash_F

(5,861 posts)
14. I will avoid merely expressing disgust at you calling him a criminal...
Fri Nov 1, 2013, 05:22 AM
Nov 2013

And try to give you a thorough response.

1) 911 is for emergencies. You may consider the walk-off of a nursing home's staff due to non-payment of wages to be an emergency, and I might agree with you, but obviously the dispatcher or police did not think so because it took multiple calls by Mr. Alvarez over 24 hours to goad them into finally showing up. So maybe you should take that up with them.

2) License revocation is not usually done in person, but by mail. With that in mind, he may not have been informed. He definitely would not have been the one to get the letter. Odds are none of the staff got the message, thanks to the derelict owners.

3) It is possible that the staff left over a period of time. In fact, I think it is likely as that is how I have seen things go in non-payment situations in my own experience. First one does not show, then another, then three at once ect. So it could have been a situation he saw deteriorate over time until he and the other guy were the last two left, rather than a sudden catastrophe of mass disappearance.

4) As for the comments about the legality giving out medication due to lack of qualification. That just exemplifies the huge disconnect between the two America's. He's a janitor. I doubt he's up on legal minutia. What do you think the 911 operator told him when he brought up that they were needing their meds? I'll give you hint: nothing. Everybody is so concerned about legal liability these days.

I am sure the police will charge this man if they find that he has done anything criminal.

The owners should have taken ownership of the situation and saw to the transfer of the seniors to another home, their families, or the state, if they could not manage to pay their staff for whatever reason. Isn't that the point of owning your own business? To take care of things? To take charge of the situation? They were the ones that failed here.

truedelphi

(32,324 posts)
42. Agree with almost everything you say, but I think the state needs to send in
Fri Nov 1, 2013, 05:51 PM
Nov 2013

Actual human beings, from Sacramento, to oversee the shut down.

State-wide, there is a total disconnect between our elected officials, of both parties, when it comes to reality.

When a bank is deemed to be failing, warm bodies are called in to oversee the bank shut down. All that is involved in that is money.

Equally important to have humans from the State Of California come in and oversee an elder care facility, where human lives are at stake.

Back in the late nineties, there was a huge concern from the public regarding the fact that hospital after hospital had fired LVN's, with one year of training, and replaced many of them with Nursing Assistants. Not to dis Nursing Assistants, but there is no way that someone who has had as little as ten weeks of nursing can fulfill the duties of a LV nurse. Especially given that often the course work offered to the nursing assistant to be is watered down by the nursing home administrators in an effort to keep their nursing homes staffed.

So when our elected officials realized there was a crisis - what did they do? Did they examine the situation, talk to nurses and LVN's and others (like doctors) who understood what had happened? If they had done that, they could have quickly written new legislation requiring the hospitals to re-hire the fired LVN's or their counterparts with LVN licenses.

Instead, and rather incredibly, the entire state legislature spent over three months discussing what they should do. Committees were formed, and these were the concerns: What sort of position should be created to deal with "the crisis?" What sort of license should be thought up, with a new clever name? What course work should be involved?

Talk about endlessly sitting in meetings to re-invent the wheel!

And on and on. I personally have lost most faith in my California state legislative critters. From Cal Trans to hospital oversight, this state is losing the battle in having solutions. Even though endless amounts of money are thrown at each and every problem.

 

happyslug

(14,779 posts)
45. He said he made several 911 calls, but only after October 25, 2013
Fri Nov 1, 2013, 06:45 PM
Nov 2013

Last edited Fri Nov 1, 2013, 08:45 PM - Edit history (1)

By late on the night of Oct. 25, he noticed some of the residents felt "clammy" and had trouble sitting up. He said he and Rowland called 911 several times when residents appeared to be sick, and finally sheriff's deputies and firefighters arrived Saturday afternoon to rescue the remaining residents.

Sorry, something is wrong, he claims to have made "several" calls to 911 on October 25, but no one appeared till Saturday October 26??? If 911 was called the 911 operators would sent someone who would have looked into the situation and report to his or superiors for assistance. This is NOT a home in the boondocks but in an urban area, someone could have been in the home within 10 to 15 minutes and the process started.

All he had to do (and appears to have done on the night of the 25th) was call 911 and request assistance. It would have been sent, as it was on the 26th. Something is wrong here, I suspect he tried to do what he thought was best, but NOT calling 911 put people in danger and along with disbursing medications without the needed training are two CRIMINAL acts he did. The acts are criminal for what he was suppose to do was call 911 on the 24th, not the night of the 25th.

I do no think he will be charged (no intent to do harm or any other criminal act on his part) but he did at least two criminal acts, NOT making sure these patients had the medical staff (i.e. calling 911 on the 24th) and disbursing medications without knowing who was suppose to get what.
.....................................................................................................................................................

After I wrote the above, other articles pointed out that 911 received four calls starting on the 24th. Furthermore two state inspectors were in the nursing home one on the 24th and another on the 25th. Neither time did they talk to the Janitor. Between those two acts, it is clear he made any call that could be expected of him and thus relieve him of an criminal act in regards to endangering the patients, but his own statement says he did NOT know what medications he was giving out, that is against FEDERAL LAW.

Now, I do NOT expect him to be charged, for other people did worse acts, namely endangering these patients when they left the patients without medical supervision. I also suspect that the two inspectors reported the situation to their supervisor, who then called the owner who did not pick up his phone. The Supervisor had been trained to get the owner to get these patients into another home (which is required by Federal Law) but had no training as to what to do if the owner just skips town. The Training assumed everyone would obey the law which is NEVER to leave these patients without care, but you had a case where that happened. No one was set up for this, worse given that such patients tend to be on welfare, hard to place in a home (most homes prefer patients with assets, the home charges a high fee to such patients till the assets, generally their home, is gone then puts the patient on welfare, thus the nursing home gets more the welfare will pay till the assets are gone, then welfare afterward).

A secondary factor is who should pay for these patients? Welfare will pay LONG TERM care, but not for moving them, thus I suspect the state and county governments argued over who was to take charge of these patients, each saying the other should (and take the hit in their budgets, for these people cost a lot of money to take care of).

LeftofObama

(4,243 posts)
15. So, using your logic, if I see a child get hurt outside
Fri Nov 1, 2013, 05:53 AM
Nov 2013

I should just call 911 and keep going on my way? Let the kid lay there and hope the rescuers find him/her? I wouldn't want to traumatize the kid by telling him/her they were going to be ok and stay until the paramedics got there because telling him/her they were going to be ok when clearly I am not qualified to make that diagnosis would put the child at risk.

 

happyslug

(14,779 posts)
46. That is the law in most states, in fact you do not even have to call 911.
Fri Nov 1, 2013, 07:04 PM
Nov 2013

One or two states have adopted a law requiring assistance in such circumstances and that is the law in Civil Law Jurisdictions (Latin American and Europe) but giving assistance to a person in need was NEVER the law in Common Law Jurisdictions. Now most states have passed "Good Samaritan" that prevent the child from suing you, if what you did to help him caused him or her more harm (again the Common Law Rule was if you helped someone, and that person was harmed by your actions, you were and are liable for the harm you did in saving his or her life).

Sorry, under the law in most states you do no even have to call 911 in the circumstances you state.

More on Good Samaritan laws:

http://www.heartsafeam.com/pages/faq_good_samaritan
http://en.wikipedia.org/wiki/Good_Samaritan_law

More on the Common Law Rule that you do NOT have a duty to rescue:

http://en.wikipedia.org/wiki/Duty_to_rescue

In an 1898 case, the New Hampshire Supreme Court unanimously held that after an eight year-old boy negligently placed his hand in the defendant's machinery, the boy had no right to be rescued by the defendant. Beyond that, the trespassing boy could be held liable for damages to the defendant's machine

BlancheSplanchnik

(20,219 posts)
54. great stuff to know! Thanks!
Fri Nov 1, 2013, 09:25 PM
Nov 2013

I, for one, definitely want to be a do-bee and a good citizen, by following the law of the land regardless of whether anyone with a sea sponge where their brain should be could see that the rule made no sense and in fact, could directly harm people.

Laws before people, I say!!!
Think of the corporate owners!!!

CreekDog

(46,192 posts)
16. you can tell us how long you think he should be in jail to make the world a better place
Fri Nov 1, 2013, 05:54 AM
Nov 2013

and how much this janitor at a nursing home should pay in monetary damages to society to make society a better place.

you just tell us how long he should be in prison to make the world a better place and how much of his vast wealth he should give up for trying to help people when all the regular staff quit before these people were placed in other homes (which is what was supposed to be done before actually closing down).

just tell us.

 

happyslug

(14,779 posts)
50. Actually no jail time for the Janitor, but someone should spend some time in jail
Fri Nov 1, 2013, 07:50 PM
Nov 2013

From other articles it appears State Inspectors were in the home on the 24th and 25th. This employee did NOT speak to either inspector. I do not see two inspections except to see if anyone was still in the home, when they found people they reported it to their superiors, who then did nothing. Someone dropped the ball in this case, either at the State Level or the County Level (I suspect both, as this case was kicked between the two to see who would take the hit on their budget). There is no reason for these people to be in this home passed the 24th except the county or the state (and probably both) wanted someone else to pay for finding housing for these patients. These people were endangered and the State and County appears to have argued about who was to pay for the problem. Thus someone should go to jail for failing to do something on the 24th.

 

Rebellious Republican

(5,029 posts)
17. More on the story, with differant source links, enjoy the read!
Fri Nov 1, 2013, 07:32 AM
Nov 2013
http://article.wn.com/view/2013/11/01/Cook_janitor_heroes_when_caregivers_walked_away/#/related_news

Seattle Post 2013-10-31: Maurice Rowland knew that the closure notice stuck on the front door of his workplace meant the assisted-living residential facility was to be closed Thursday night because of a license revocation. But why, he wondered, were 19 of the center's 32 residents still there - some with Alzheimer's, others with what he believed to be schizophrenia, all of them hungry and wanting dinner. Almost all the caregivers had left. The manager and owners were nowhere to be found. Rowland was the cook, hired three months earlier to prepare meals for the residents at Valley Springs Manor in Castro Valley. "I didn't know what was... more »
 

happyslug

(14,779 posts)
48. State Inspectors were in the home on the 24th AND the 25th???
Fri Nov 1, 2013, 07:24 PM
Nov 2013
Eleven of about 30 residents did get a new place to live, but on Oct. 24, when the facility's license was officially suspended, 19 residents were still at the facility.

State authorities visited the home that day and the following day, Weston said.


911 says it received only four calls. An inspector from the state was in the residence on the 24th AND the 25th. Now, we are getting to the people who broke the law without justification. I wrote above that giving medications was a criminal act unless supervised by a licensed person (Generally a Nurse, can be a Doctor). And by NOT calling 911 on the 24th he put the patients in danger. It appears he DID call on the 24th (Thus fulfill his obligations to report the situation) but he did give out medication without proper supervision.

The real problem was the 911 operator somehow did not understand how bad the situation was (probably dismissed the call as a patient unhappy with bring in a nursing harm, but need to be in one) AND the state inspectors did not report the situation (or did report the situation but told to go to their next site to inspect and the agency would take care of the situation, and the agency did not for it was depending on the families of the patients to do so). We still have Criminal Neglect, but it appears from this report to be at county or state level.
 

Katashi_itto

(10,175 posts)
19. I shall keep your response in mind the next time I am in a good samaritian
Fri Nov 1, 2013, 09:12 AM
Nov 2013

situation. Should I stay and help withing the best of my abilities and get labeled a criminal. Or just go about my business.

Hmmmm

LisaL

(44,967 posts)
20. From what has been reported, 911 was called multiple times.
Fri Nov 1, 2013, 09:16 AM
Nov 2013

So it's extremely unfair to blame the guy.

 

happyslug

(14,779 posts)
49. I didn't blame him, I just pointed what he did was a technical crime.
Fri Nov 1, 2013, 07:41 PM
Nov 2013

Now, from other articles it appears the State had inspectors in the home on the 24th and the 25th. Thus the state knew of the problem. Any duty to report ended with those inspectors, who should have done something (I suspect they did, but their supervisor then failed to do anything based on their report).

As to the crime of giving out medications, that is a crime he admits to doing, It is clearly illegal for he was NOT supervised by anyone who could authorize giving out those medications (and how he did it clearly show he did not know what he was doing, and that by itself was illegal). Now, he also faced a situation where he clearly did not intend to violate the law (and for that reason I do not see him being charged).

My comment was that something was wrong, and the more I find out about this case, the higher it goes to who is to blame. Right now, I suspect the supervisor of the State Inspectors failed to call in the people to get those last patients out (instead relied on the owner of the home, who the supervisor tried to call, but received no answer and then waited for the owner to return the call, a return call that never came).

Remember this type of housing is the most expensive type of housing and the hardest to place. All are on Welfare, for that is who pays for long term nursing home care (Nursing Homes charge people a high rate till any value in their own home is gone and all other assets are gone, then put the person on welfare). Given these people have no assets, no one wants them. The County and the State probably kicked this case back and froth, hoping the other would take the hit to their budget. Then it hit the papers as it exploded in their faces.

 

ConcernedCanuk

(13,509 posts)
23. Your empathy meter is broken
Fri Nov 1, 2013, 09:22 AM
Nov 2013

.
.
.



and what would you have the "law" do to this terrible man?

from the link in the OP:

Alvarez - who still has not received pay for any of his work at Valley Springs Manor - slept on a rocking chair in the TV room, afraid to leave the residents alone overnight. Doling out medications was the toughest part; he didn't know who got what, or how much.

"The residents would say, 'I get five of those!' Well, I didn't know," he said, adding that five pills seemed like too much to give anyone. He said some residents never received any medications.

By late on the night of Oct. 25, he noticed some of the residents felt "clammy" and had trouble sitting up. He said he and Rowland called 911 several times when residents appeared to be sick, and finally sheriff's deputies and firefighters arrived Saturday afternoon to rescue the remaining residents.

"I just thought, 'Thank God, now they'll be safe,' " he said. "I just went home and slept."


______________________________________________________________________________________

My hat is off to Miguel Alvarez

you did good



CC

 

L0oniX

(31,493 posts)
24. Message hidden by jury decision.
Fri Nov 1, 2013, 11:32 AM
Nov 2013

There's something wrong with DU when people like you can post here.

Gormy Cuss

(30,884 posts)
26. Send it to a jury. I predict it will be allowed to stand
Fri Nov 1, 2013, 12:14 PM
Nov 2013

because it's just an opinion. Cuz ya know, all opinions are equally valid.

Response to happyslug (Reply #12)

colorado_ufo

(5,729 posts)
28. Good Samaritan rules should apply here.
Fri Nov 1, 2013, 03:39 PM
Nov 2013

I have done the type of work that this poor man attempted to do without help, except for that of the courageous cook, and I can tell you from first hand experience that this is a massive job even WITH help. This would be considered a huge patient load for a shift, and if you throw Alzheimer's into the mix, that really puts it over the top into Labors of Hercules territory. Have you ever had to change diapers and soiled bedsheets? Manage combative patients without getting hurt? Had to spoon feed dinner to four or five helpless people - in different rooms - at the same time? Turn unresponsive patients larger than yourself, so that they would not get bedsores? Try to move fragile older people without breaking bones? And on and on and on.

One thing also is not emphasized: When the owners got this notice, were the families contacted? If not, why? Maybe there was no family left to contact. Maybe they just didn't want to miss a paycheck.

If ever fate puts me in the position of one of those helpless residents, I hope that there will be a Mr. Alvarez there to valiantly help fight for my existence until help arrives. And if he gave me the wrong medicine, or broke my leg, or otherwise and unwillingly hurt me, my only thoughts and words for him -- and for the cook who would not let me starve -- would be ones of gratitude.

noiretextatique

(27,275 posts)
32. no, the management and staff who left put them at risk
Fri Nov 1, 2013, 04:01 PM
Nov 2013

someone should have made arrangements to move the residents to another facility...perhaps it should have been the state?! thank goodness for the janitor and the cook...otherwise those people might have been left alone for says without food or water or meds.

 

happyslug

(14,779 posts)
57. By Federal Law that is what suppose to have been done
Fri Nov 1, 2013, 10:41 PM
Nov 2013

You must understand, long term nursing care is paid for by the Federal Government (with matching state funds) if the federal requirements are followed. Since the States want the Federal funds, every state follows federal law on this subject.

You can NOT move a person out of a Nursing home without that person's permission OR to another nursing home. That is a federal mandate. It appears in this case that the license was revoked by the state and then the state sent in inspectors on the last day of legal operation (24th of October) and the day after (the 25th of October). During either inspection did the inspector talk to the janitor.

911 admits they received four phone calls, but only send in someone on the 26th. I suspect what happen is the following:

1. License was revoked and the nursing home was told to move the patients elsewhere

2. The Nursing home told the families of the patients to move their relatives to another nursing home

3. Some families were able to find another nursing home or took in the patient themselves,.

4. Other families could not do either, so the patient stayed in the home.

5. This Janitor was hired the week of the 15th, after I suspect the previous janitor quit due to a failure to be paid. This Janitor was told he was to be paid on the 25th (Which was a friday).

6. The Nursing staff (mostly nurses aides but should include be a registered nurse on staff, but I suspect the license was revoked for their had no Registered Nurse on Staff and no Licensed Practical Nurse, LPN available 24 hours 7 days a week) quit when they were not paid on the 4th, 11th or 18th (The previous three fridays).

7. When the nursing staff left these two last hires remained for they did not know that they would not be paid.

8. I suspect some of the nursing staff stayed till Wednesday helping people pick up their relatives, but the number steadily fell till it was to much for even the remaining staff so they left. From the last day they were paid to Wednesday the Staff called the State Regulatory agency and asked what they should do. The State Agency refused to tell them what to do for the state did not want them to leave, but the state Agency also did not want to tell them to stay for that may make the state liable for the days they worked after they called the agency. Thus the staff was told nothing except to call their employer.

9. The State sent in an inspector on Thursday October 24th, 2013 and reported that there was no staff, just a cook and a janitor and the inspector could NOT locate the owner. This report was phoned in to the state inspectors supervisor. The State Agency Supervisor then called the number for the owner of the Nursing home and left a message on an answering machine to return her call. The Supervisor does nothing more for her training book clearly says the owner of the nursing home is the primary care provider and if there is any problems, call the owner and get the owner to fix the problem. Training may be FORBID any action by the state agency until they hear from the owner.

10. The State Agency local supervisor NOT getting a return sent in a second inspector who is told to get in touch with the person in control of the home. The problem is no one is in control and that is what the second inspector reports. The Supervision, going by what she was trained to do, again called the owner and left a message to call the Supervisor.

11. In the 24th the Janitor called 911 and was told to call her employer instead

12. On the 25th the Janitor called 911 a second time, again told to call his employer.

13. On the 25th the Janitor called again and this time told to call the State Agency (which I suspect he did but no one is admitting to it).

14. Late on the 25th the Janitor calls 911 and this time reports someone having severe medical problems, so 911 sends out EMT unit, who arrives and report back to headquarters that the place has no staff and all are in need of medical care.

15. The EMT term stables the situation (they have the training to do that). The EMT term reports that all of the patients are in need of medical care but are stable. 911 term then works out an emergency plan to put these patients into various other medical care facilities on Saturday October 26, 2013.

16. The janitor and the cook go home and the reporters have a hot item for their sunday papers.


I have to credit the janitor and the cook for staying so long, but I have to say this in his first 911 call he should have said all of the patients are in need of emergency care and force the hand of 911 to do something. I suspect to many people was passing the buck in this situation to every one else but themselves (including 911, but they should be rewarded for they did finally do something before someone died).

pothos

(154 posts)
34. This is one of the most ridiculous things I've ever read. Disgusting.
Fri Nov 1, 2013, 04:08 PM
Nov 2013

In addition to all the other replies, you have to understand that people in minorities communities don't necessarily feel super comfortable calling the cops.

 

happyslug

(14,779 posts)
59. He called them four times.
Fri Nov 1, 2013, 10:58 PM
Nov 2013

Another article posted above, point out the Janitor called 911 Four times (as reported by 911) and that the State sent two inspectors, one on the 24th and another on the 25th The inspectors did not talk to the janitor at all.

I will not repeat what I have written above, but something is wrong here and I am looking at the State Agency. We can assume the owner of the Nursing Home committed all types of crime, but that does NOT excuse the State from doing its job of protecting these people in this nursing home, when the state is paying for their care.

 

happyslug

(14,779 posts)
58. I deal with nursing homes all the time.
Fri Nov 1, 2013, 10:52 PM
Nov 2013

I know the Federal regulations and Statures that apply to them. Something is wrong here. Under the law as written this should NEVER have happened. Those patients should NEVER have been without a care giver with as least a nurse aide training. Furthermore a LPN should have been on duty all of the time (and a registered nurse somewhere in staff).

When the staff left the state should have immediately stepped in. For some reason the state did not. 911 stepped in and that is funded NOT by Welfare but Homeland Security. Something is very wrong in this case and people should go to jail. The two that stayed committed minor crimes and I do NOT see them being charged (I pointed out that the crimes they did were technical crimes, no intent to do anything criminal was shown by their actions). On the other hand leaving people who you had agreed to take care of is a violation of Federal law (Through it is only dealing with funding for nursing home) and state laws (which may include some criminal elements).

My original statement still holds true, something is wrong her, what it is I do not know, but I know enough that something went wrong big time.

wordpix

(18,652 posts)
66. duh, something is wrong here, this whole facility was bad news and the state wasn't on top
Sun Nov 3, 2013, 12:23 AM
Nov 2013

of things, either.

 

LanternWaste

(37,748 posts)
38. Illustrate the strength of your convictions and call the cops if you think he's a criminal...
Fri Nov 1, 2013, 04:26 PM
Nov 2013

Illustrate the strength of your convictions-- call the cops if you think he's engaging in criminal behavior and try to get him put away.

Or, you could simply rationalize what you've written, maintain your position at the keyboard, and wipe the drool off your chin (if any, or course).




My own guess is the second option will be taken without thought, as the first requires more courage and sincerity than many people yet have...

Yo_Mama

(8,303 posts)
47. He falls into the category of a bystander who assists
Fri Nov 1, 2013, 07:17 PM
Nov 2013

He was a janitor. He probably didn't realize what had happened entirely until the 24th.

If you are walking along the sidewalk and somebody topples over and starts gasping for breath, yes, you call 911 and then you try to help. You are not held to the same standards as anyone who is a health care professional.

 

happyslug

(14,779 posts)
51. That is NOT the Common Law Rule
Fri Nov 1, 2013, 08:26 PM
Nov 2013

Now California is one of 10 states that have a law requiring people to notify police but only of crimes where the victim is under age 14, thus it does NOT apply in this case:

152.3. (a) Any person who reasonably believes that he or she has observed the commission of any of the following offenses where the victim is a child under the age of 14 years shall notify a peace
officer, as defined in Chapter 4.5 (commencing with Section 830) of Title 3 of Part 2:
(1) Murder.
(2) Rape.
(3) A violation of paragraph (1) of subdivision (b) of Section 288 of the Penal Code.
(b) This section shall not be construed to affect privileged relationships as provided by law.
(c) The duty to notify a peace officer imposed pursuant to subdivision (a) is satisfied if the notification or an attempt to provide notice is made by telephone or any other means.
(d) Failure to notify as required pursuant to subdivision (a) is a misdemeanor and is punishable by a fine of not more than one thousand five hundred dollars ($1,500), by imprisonment in a county
jail for not more than six months, or by both that fine and imprisonment.
(e) The requirements of this section shall not apply to the following:
(1) A person who is related to either the victim or the offender, including a husband, wife, parent, child, brother, sister, grandparent, grandchild, or other person related by consanguinity or affinity.
(2) A person who fails to report based on a reasonable mistake of fact.
(3) A person who fails to report based on a reasonable fear for his or her own safety or for the safety of his or her family.


http://www.leginfo.ca.gov/cgi-bin/displaycode?section=pen&group=00001-01000&file=142-181

Thus, even in California, you do NOT have to call 911 in your hypothetical. You can just keep on walking and you would have violated no law. If you helped the person, you can be held liable for any harm you did (and thus I would advise you to all 911 to minimize any harm you may do).

Now, based on the facts in this case, he was an employee of his employer. The Employer had contracted with these patients to take care of them and that duty of care extended to the employees. Thus even under the Common Law, the employee had a duty to take care of these people until relieved of that duty, a relief the STATE failed to do till the 26th.

Now, there are restrictions as to how LONG a time period such care can be provided. Prior to 1865, no restrictions existed as to the length of care that could be expected, but in 1865 the US passed the Amendment that outlawed Slavery, which put a restriction as to how long you can demand someone to take care of someone who is not a blood relative (I.e. to long a duty you are making someone a slave and that was illegal after 1865).

The courts have been reluctant to determine when it is reasonable for someone to leave someone that the first person had a duty to take care of, but the person doing the care is doing it for no compensation. In most cases either blood relatives take up the duties (the traditional method) or in many modern situations for in most cases the State steps in and takes over the duties.

In this case the state took over on the 26th of October. My position is this employee had a duty (along with his employer and the other employees of the home) to take care of the patients till the State took over. I suspect that is what the State was counting on, but the employer skipped town, something the State and County was NOT expecting (Yes, I believe they should have been expecting it, but I suspect the State refused to even consider it possible). For skipping town the employer should be jailed, but I doubt he or she ever will be.

Just explaining who had a duty in this case. This employee fulfilled his duties, but the Employer clearly did not.

Yo_Mama

(8,303 posts)
55. It's true that you do not have a duty to call
Fri Nov 1, 2013, 10:03 PM
Nov 2013

But that's not what I was referring to.

Attempting to render basic aid to someone who is in physical distress does not imply a legal liability for malpractice when the person is not a healthcare professional and the person is doing something sort of in the common run. This man was in the position of a guy walking past a person convulsing breathlessly with an acute asthma attack trying to find a dropped inhaler who grabs the inhaler and hands it to the person, probably.

I guess since the employees were not being paid none of them had a legal duty to take care of the abandoned patients - much less the janitor.

I agree that the employer should face criminal penalties. If the employer doesn't it's a travesty.

CA does have Good Samaritan law, and I think most judges would construe abandoned nursing home patients as an emergency.
http://law.onecle.com/california/health/1799.102.html

It is, I grant you, an emergency that should not have happened, but ... it did. I'm still having trouble assimilating the course of events here.

However I believe that the poster who said the janitor was breaking the law was in error, especially if the person believed help was coming and especially since the person called 911 when he realized it was not.

Bringing food, water and handing someone their medications seems likely to fall within the scope of the Good Samaritan code.

passiveporcupine

(8,175 posts)
56. the employee had a duty to take care of these people until relieved of that duty
Fri Nov 1, 2013, 10:38 PM
Nov 2013

Are you sure about that?

He was not hired as a care-giver. He was hired as a janitor, and the other as a cook. He was not caring for patients, just cleaning the facility. He could have been a gardener, fresh up from Mexico, who couldn't even speak English, and you think he would have been responsible for taking over a job that requires skills, training, education and licensing?

I think the nurses were responsible, if the manager or owner walks off, because they were hired for that duty.

That is like saying if you were hired as a surgeon...and you walked off the job, your ER nurse would be responsible for finishing the operation for you.

You seem to be struggling mightily to keep coming up with reasons to defend your absolutely unfeeling response to this situation.

Many people in his situation might have panicked and run. He stayed and did his best to try to help. The state inspectors who came and left even after finding no one there to care for the patients...he/she was the one who should be held responsible. And the last nurses who left (or head nurse). Why weren't the last nurses calling 911 and saying these people were being abandoned?

 

happyslug

(14,779 posts)
60. Under the common once he starts to help someone he can not stop.
Fri Nov 1, 2013, 11:06 PM
Nov 2013

Thus once he started to help these patients, he had to continue till he was relieved. Now he was hired as a janitor and thus had no duty to these patients, but once he did start to help the patients he was under a legal duty to continue. You can NOT assume a duty and then abandon it, even if you had no duty to assume the duty in the first place. i.e. if he had done his janitor work and left, he would have been under no legal duty to these patients. His liability to them only started when he started to help them.

Yes, it is a fine line, but it is the law and has been the common law rule for centuries.

 

happyslug

(14,779 posts)
68. First it is case law. the Wikipedia cite does a nice overview
Sun Nov 3, 2013, 09:10 AM
Nov 2013

Last edited Sun Nov 3, 2013, 12:18 PM - Edit history (2)

What I mean by case law, is the courts have found it to have been the law since the middle ages and the states have NOT passed a statute on the same subject. Under the Common Law, which applies to the Federal Government and all 50 states (with some exceptions in Lousianna) such case law is the law UNLESS expressly overturn by the courts OR by a Statute passed by a state legislature.

http://en.wikipedia.org/wiki/Duty_to_rescue

http://en.wikipedia.org/wiki/People_v._Beardsley

Beardsley is cited in Jones vs the United States a 1962 case:

There are at least four situations in which the failure to act may constitute breach of a legal duty. One can be held criminally liable: first, where a statute imposes a duty to care for another; second, where one stands in a certain status relationship to another; third, where one has assumed a contractual duty to care for another; and fourth, where one has voluntarily assumed the care of another and so secluded the helpless person as to prevent others from rendering aid.


http://scholar.google.com/scholar_case?case=14703438613582917232&hl=en&as_sdt=6&as_vis=1&oi=scholarr

14 For criminal liability to be based upon a failure to act, there must be a duty imposed by the law to act, and the person must be physically capable of performing the act. See § 45-2-202, MCA. As a starting point in our analysis, the parties here have identified what is often referred to as "the American bystander rule." This rule imposes no legal duty on a person to rescue or summon aid for another person who is at risk or in danger, even though society recognizes that a moral obligation might exist. This is true even "when that aid can be rendered without danger or inconvenience to" the potential rescuer. Pope v. State (1979), 284 Md. 309, 396 A.2d 1054, 1064 (quoting Wayne R. LaFave & Austin W. Scott, Jr., Criminal Law, at 183 (1972)). Thus, an Olympic swimmer may be deemed by the community as a shameful coward, or worse, for not rescuing a drowning child in the neighbor's pool, but she is not a criminal. See LaFave & Scott, Substantive Criminal Law § 3.3(a) (1986).

¶ 15 But this rule if far from absolute. Professors LaFave and Scott have identified seven common-law exceptions to the American bystander rule: 1) a duty based on a personal relationship, such as parent-child or husband-wife; 2) a duty based on statute; 3) a duty based on contract; 4) a duty based upon voluntary assumption of care; 5) a duty based on creation of the peril; 6) a duty to control the conduct of others; and 7) a duty based on being a landowner. See LaFave & Scott, § 3.3, at 283-289. A breach of one of these legal duties by failing to take action, therefore, may give rise to criminal liability. Our review of the issues presented here can accordingly be narrowed to two of the foregoing exceptions as briefed by the parties and identified by the District Court: 1) a duty based on a personal relationship, and 2) a duty based on creation of the peril.


http://scholar.google.com/scholar_case?case=12318759535516191060&hl=en&as_sdt=6,39&as_vis=1

passiveporcupine

(8,175 posts)
69. under voluntary assumption of duty to provide care:
Sun Nov 3, 2013, 06:11 PM
Nov 2013

Voluntary Assumption of duty

a. Must rescue in a reasonable manner

b. If have special skill set, standard of care is reasonable person with the
same skills


c. If ∆’s negligence places good Samaritan rescuer in harm’s way, ∆ is also
liable to rescuer

If I read this correctly, only someone with a valid skill set (i.e. a nurse or someone trained in that care) is liable in voluntary assumption of care. Not a janitor or cook who does not have that skill set.

The only problem I see with his actions is that of giving medication to the people who were undoubtedly screaming of it. Even if he had no idea it was illegal to do so, he might be held liable for giving the wrong medication to someone if it caused their death or a severe health problem, which may have actually happened in this case. We may never know. I can see a family member suing him for giving the wrong pills to Grampa and he dies as a result.


The part I'm having trouble with is the 911 calls. I wish someone would release those calls. There was a nurse or admin or someone on duty until the end of the workday on Saturday. Then they walked off. That evening he called 911 saying the patients needed help. I don't know if he said they needed meds and he didn't know what to do. There is no information given on how they responded to him. It does seem to look like the 911 operators either didn't get a clear picture of what was going on, or they didn't help him the right way. Maybe that will come out later.

 

happyslug

(14,779 posts)
70. Not my take in the rule
Sun Nov 3, 2013, 08:42 PM
Nov 2013

The bold face text I cited above is more the rule. Any assumption of the duty even if the person is incompetent. Skills are not a factor, just doing it is enough.

polly7

(20,582 posts)
21. Miguel Alvarez is a hero.
Fri Nov 1, 2013, 09:17 AM
Nov 2013

What he did for those dozen people will never be forgotten by them or their families. It's had work when you've got the training, for him to step up and do it himself is just beyond heroic. Makes me emotional just thinking of how grateful they'd have been to see him come to tend to them.

Brigid

(17,621 posts)
30. He certainly is.
Fri Nov 1, 2013, 03:51 PM
Nov 2013

I do not know how the rest of the staff, and especially the management, could just walk away and do nothing about the patients who were left at the home. I do not know why repeated calls to 911 produced no results. But Mr. Alvarez and that cook put them all to shame.

polly7

(20,582 posts)
31. I don't understand it either.
Fri Nov 1, 2013, 03:58 PM
Nov 2013

All of the residents I've ever taken care of were almost like family after a few days of looking after them, you grow to love them like children in your care. And many of them are nearly as helpless as infants - to imagine them on their own, hungry and soiled and feeling abandoned is just too awful. They would be so afraid. I hope there's good karma in store for Mr. Alvarez and the cook.

Mr.Bill

(24,218 posts)
52. Any licensed medical professional (CNA, RN, LVN, etc.) who walked out of that facility
Fri Nov 1, 2013, 08:54 PM
Nov 2013

should lose their license. It's called patient abandonment, and can be cause for having your license revoked. I wonder if a lack of properly licensed people is why they got shut down in the first place.

 

happyslug

(14,779 posts)
61. My suspicions is they have NOT had a RN in months, if ever
Fri Nov 1, 2013, 11:31 PM
Nov 2013

I also suspect the LPNs left months ago do to problems with pay, Thus the home was staffed with nothing by CNA (Certified nurses aides) who quit at the beginning of the month and the home has been hiring people off the street for at least the last couple of months to minimize costs. When the LPNs left the CNA were still working. When the CNAs quit, the new hires were present to take care of the patients. The new workers had been hired at minimum wage without any training, and they were the only people left when this janitor and cook were hired.

Worse, I suspect none of these workers were paid all month. The employer hired replacement workers when old workers walked off the job do to lack of pay. i.e. people stayed on the promise of pay, by the pay was never paid. Thus this janitor was hired to replace a janitor who quit do to NOT being paid. It takes months to revoke a license and if the owner never intended to fix the problems, they could run such a shell game (for that is what is was) till the license was revoked. i.e. NOT pay anyone. Any RN would have quit months ago (if they ever hired one, I suspect they did not for they KNOW they have to be paid), any LPN would have quit months ago, the CNAs after missing two to three pays. After a while the word gets around about a bad employer among licensed professionals and they do not even apply for employment is such places.

Lower income people would stay longer for their have even fewer options. Worse, not being of the same group as even the CNAs, they would NOT have heard this was an employee who does not pay. If what happened to this Janitor is typical, hired and then never paid, would explain why no one was left except the cook and Janitors who were also the last hired. Even one else left for they had NOT been paid for even people who are the most desperate for work, want to be paid.

Thus any RN, LPN or even CNA would have complained to their licensing board long before now AND spread the word NOT to even think of working for this employer. I suspect the owner had no RNs, no LPNs and no CNAs on his staff for at least the last month. The owner took the money and ran, something no one planned for.

Mr.Bill

(24,218 posts)
62. I think you are correct.
Sat Nov 2, 2013, 12:17 AM
Nov 2013

I can't see any licensed professionals just walking away and leaving patients when the place shut down.

wordpix

(18,652 posts)
67. you may be right in your guesses BUT I just spoke to staff at a facility about this
Sun Nov 3, 2013, 12:27 AM
Nov 2013

My mom is in a dementia facility. Two of the staff there said they would have done the same thing if they hadn't been paid (although they didn't say not paid for how long). I could not believe they said this. They are well trained, the place is well staffed and these two are (or seem to be) nice people. Now I'm not so sure.

AnnieBW

(10,407 posts)
53. Speaking as someone with an elderly parent in a facility
Fri Nov 1, 2013, 09:01 PM
Nov 2013

Goddess bless this man. My mom is in a rehabilitation facility, and I'm very grateful to them for taking good care of her. If something like this happened to my Mom, I'd be freaking out.

yurbud

(39,405 posts)
64. another thing the private sector does better than
Sun Nov 3, 2013, 12:09 AM
Nov 2013

okay, even the Soviets could do better than this.

wordpix

(18,652 posts)
65. as the daughter of an advanced Alzheimer's patient, I'm aghast
Sun Nov 3, 2013, 12:20 AM
Nov 2013

WTF? People should go to jail over this and NOT the janitor, who's a hero in my book. Sure, he should not have dispensed meds but obviously he was overwhelmed and trying to do his best.

The owner and manager of this facility should be in jail. I have sympathy for the unpaid workers who left in that they weren't paid for 2 weeks and got fed up, but they should not have left the patients. That is unacceptable. These dementia patients are like children and some, like my mother, have returned to baby-like states and can do nothing for themselves. Would you leave 19 babies and young children alone, even if you weren't paid? I wouldn't. I would be taking care of them but calling for help until I was blue in the face. I would deal with the owner of the facility and my pay later.

And the families of those patients should be ashamed of themselves. This facility had lots of problems leading up to the closure but either they didn't care to visit or didn't care, period. You can tell a decent facility by things like smell, cleanliness, food that's served and appearance of patients. If something is awry, you need to act. There was a lot wrong with this place but the poor elderly were just dumped there as someone else's problem.

Then there was dereliction of duty on the part of the state. Nuff said. Heads should roll.

Bad, bad, bad all around.

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