PATIENT ABUSE & RAPE
Daycare - Skilled Nursing - Long Term Care Facilities
By Michael Panish
Door & Premises Security Expert Witness
Rape and patient abuse are more prevalent and common place in daycare and
long term skilled nursing facilities than anyone would think possible.
Across the country, patients in long term care and skilled nursing facilities
are frequently subjected to one of the most heinous acts imaginable. Victims
of these horrible crimes have been elderly men and woman, debilitated
young people suffering from diseases such as multiple sclerosis, ALS or
the latter stages of AIDS. Mentally handicapped patients participating
in adult day care activities and out-patient transportation services have
been victimized as well.
After being involved as door and security expert in over two dozen cases,
it seems that crimes of this nature have no pattern or consistency, with
one exception. It does not seem to matter about the age, sex, race, religious
affiliation, or physical condition of the victim. The cost of care at
a facility doesn't seem to be a factor either. The one consistent
factor that has been common in all of the cases I have been involved with
is the lack of appropriate supervision and management of the care facilities,
staff, or organizations where these violent crimes took place.
Attorneys have asked why I have been involved in so many rape and abuse
cases. As a building contractor, I have a substantial background building
and renovating long term and skilled nursing facilities of many kinds.
I own and maintain a door, lock, and security hardware business that provides
services for periodic inspections of doors and hardware, ADA compliance
issues, and life safety. My door and hardware company has provided many
facilities with proprietary master key systems that control access to
areas by tiered status. As an electrical contractor, I have designed and
installed card key access and video surveillance systems that attempt
to limit and control access through supervised oversight. I have been
responsible for helping to develop policies and procedures, and provide
and install access equipment that dictate the way that everyone gains
entry to secure facilities such as jails, courts, government facilities,
laboratories, hospitals and hotels.
Typically, I will receive a call from an attorney that has learned either from
verdict searches or other attorneys that I have been involved in a previous elder abuse
or rape case. In prior abuse cases, my expert services have been broad
and comprehensive. I have been retained as the security expert able to
offer opinions about the overall access controls found in a facility.
I have opined about the type or lack of surveillance systems that are
in place. From a general contracting perspective, I have made observations
about the construction, prior renovation work and design of the facilities
involved. As a door and hardware service provider, I have offered opinions
about elopement issues with patients suffering from dementia or Alzheimer's.
I have commented upon the observed conditions of the door access and key
systems in use.
Abuse and rape cases have always seemed to have a common thread found during
discovery and case investigation. In almost every case poor management
practices and the lack of personnel screening prior to hiring an employee
have created the opportunity to expose the patients to harm.
I always suggest that a site visit be made to the facility where the incident
took place. In many cases, while visiting these facilities, I have been
able to wander into the buildings, roam the grounds unchallenged, and
actually enter patient rooms through unsecured doorways. In several cases,
the patient room exterior doors were left open even though they were adjacent
to a busy street.
Discovered in other cases, known sex offenders were living in proximity
to a long term care facility. The facilities management still had no policies
or provisions to observe or monitor the surrounding property or access
into the patient care areas. In one such case, a known offender was caught
raping an elderly woman at one of these properties. This person actually
left the property and returned multiple times to assault the plaintiff
prior to being apprehended by local police for another crime.
SKILLED NURSING & LONG TERM CARE FACILITIES
There are many aspects to running skilled nursing and long term care facilities.
Government regulations attempt to provide guidelines for appropriate management
and patient care. But the government does not offer permanent supervision
or observation of how a facility is operated once their investigations
are completed. Often, the facilities are owned by a remotely run corporation.
Many of those corporations operate their facilities using incentives for
their local managers. In essence, if the overall cost to run the facility
is kept at a certain level, the manager will receive a bonus at the end
of the year. If significant costs can be reduced, other rewards will be
given to the local managers. Through discovery in the cases where I provided
expert services, managers often conceived devious and unprofessional means
to reach these goals. No matter what the monthly cost to the resident
or quality of care promised, unscrupulous managers and patient supervisors
were often found involved in some sort of efforts to lower the overall
operating costs of a facility.
SOME COST CUTTING METHODS
- Laying off in-house maintenance staff – Can result in deferred conditions
of doors systems, locks, and surveillance equipment.
- Choosing to NOT hire outside professional service providers to maintain
proprietary security equipment – Often leading to the partial coverage
of facility areas.
- Hiring fewer numbers of, or eliminating guards completely- resulting in
a limited or complete lack of presence of a security force to insure patient
safety throughout the facility.
- Hiring undocumented, or false documented workers that cannot pass background
checks due to their past criminal records in other countries.
- Opting to NOT require access badges to restrict patient/staff and workforce
- Failing to maintain a reception counter continually staffed to monitor
the people entering and leaving the facility.
- Deciding to not enforce single access points where all visitors must enter
and leave through restricted doors.
The above list of cost cutting choices are often a small part of a larger
suspicious picture. You choose a specific facility with the belief that
your loved one is safe, secure and professionally taken care of. But,
in many aspects financial issues that are dictating the behavior of the
management behind the scenes are leading to potential catastrophic risk.
Previous cases have shown that the workers, floor nurses, kitchen staff
and janitors were never checked for prior criminal records or deviant
acts before being hired to work in these facilities. In several cases,
undocumented and illegal workers were hired with false papers that were
so obviously incorrect that it was apparent that the managers were not
concerned with the quality of employees that they would hire. The management
chose to hire these workers to cut operational payroll costs.
In many cases relatives of the victims thought that they had researched
the operation and services of the facility thoroughly prior to moving
patients into their care. They routinely visited their parents, and were
completely unaware of the abuses that were occurring all around them.
Most relatives of residents that are made aware of an assault cannot believe
that it would happen. "The facility seemed so nice, clean and friendly!"
Every case is different. There are obviously many professionally run long
term and day care facilities across the country. Unfortunately, it is
the facilities that are not properly managed and maintained that compromise
the care and safety of their residents and patrons.
Michael Panish has participated as the door and security expert witness
and consultant in dozens of rape, assault and elder and patient abuse
cases throughout the United States. He has been the
retained expert on several cases that have set the legal standards for adult long term care facilities.
Mr. Panish is a licensed General, Door, Hardware, Lock and Security, and
Electrical Contractor in the state of California. He is a General Contractor
with many years of experience building and renovating medical buildings,
hospitals and long term skilled nursing and day care facilities. He maintains
offices in New England and Southern California. He is available for immediate
consultation and has the experience you need to assist you with your abuse case.