Sunday, January 21, 2007
Stetson University College of Law is proud to present two outstanding seminars: "The Basics of Social Security Practice" and "Advocacy Skills in Social Security Disability Practice" at the Marriott Suites on Sand Key located in Clearwater Beach, Florida. The objective of these seminars is to continue to provide an in-depth review and discussion on a basic and an intermediate level of the major issues presented in a Social Security Disability Practice. To receive the "Early Bird" tuition rate, registration form must be postmarked by February 9, 2007. Click here for FULL ONLINE CONFERENCE BROCHURE & REGISTRATION FORM
The U.S. Department of Transportation has announced a total of $2.7 million for eight U.S. cities to demonstrate how Intelligent Transportation Systems (ITS) can improve access to transit services for older Americans and persons with disabilities. The ITS mobility projects are part of the Department’s effort to address rising transit costs and provide better service to Americans with special needs. The following cities will receive funds through the Federal Transit Administration to plan and design the demonstration projects, which may be eligible for additional deployment funding: Aiken, SC; Atlanta, GA; Cherry Hill, NJ; Fitchburg, MA; Kent, OH; Louisville, KY; Paducah, KY; and Orlando, FL. Intelligent Transportation Systems use advanced communications technologies to improve transportation safety and operations. The Department’s ITS program is managed by the Research and Innovative Technology Administration. For more information, visit www.its.dot.gov. .
Friday, January 19, 2007
First National Symposium on Ethical Standards for Elder Mediation April 19-20, 2007, Philadelphia, PA
Symposium Overview The First National Symposium on Ethical Issues for Elder Mediation will be held April 19-20, 2007 at Temple University's James E. Beasley School of Law. The Symposium will feature Harry R. Moody, Nancy Neveloff Dubler and Robert Baruch Bush who will be joined by distinguished panelists from the fields of mediation, elder law, gerontology, bioethics, and geriatric healthcare in an effort to examine the ethical issues that arise during mediation involving older adults.
The First National Symposium on Ethical Issues for Elder Mediation is an effort to address the special practice issues that arise when working with the older population. What makes elder mediation different from other areas of practice is that it is often multi-party, multi-generational and multi-issue. When a physical or cognitive impairment impedes an older adult's participation in the process, mediators are working to find ways to accommodate the older person in order to use the process safely and effectively. It is imperative to examine how to prevent a vulnerable adult from becoming more vulnerable during the mediation process. The Symposium will seek to prevent such potential harm by posing the following questions:
* What are the ethical issues involved in elder mediation?
* How do existing ethical standards apply in elder mediation and are additional standards needed?
* What is the impact of societal bias regarding aging upon the value of self-determination and the mediation process? Upon mediator neutrality and impartiality?
* What is sufficient capacity to participate in mediation? Under what conditions? Who determines capacity to participate?
* What are the ethical responsibilities of the mediator when a capacity issue is identified?
* Do new ethical and practice issues arise for the mediator when the content of the dispute has ethical dimensions?
Planners of the Symposium include Montgomery County Mediation Center (MCMC), a non-profit community mediation center in Pennsylvania that has developed expertise in elder mediation, the Elderly Law Project of the Temple University James E. Beasley School of Law, and the Institute for the Study of Conflict Transformation, Inc., (ISCT) a national think tank on conflict interaction.
Members of the National Elder Mediation Network organized by The Center for Social Gerontology will participate in the Symposium and the Network's annual meeting will be held in conjunction with the event.
If you would like registration information, please contact the Symposium Coordinator Kathryn Mariani at (610) 277-8909 or email:email@example.com.
The Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA) repeals the estate tax in 2010. During the phase-out period, the new law increases the exempt amount to $3.5 million by 2009, lowers the top rate to 45% by 2007, and repealed the federal credit for state death taxes in 2005. The federal gift tax remains though the rate is reduced to the top personal income tax rate. After repeal of the estate tax, carryover basis replaces step-up in basis for assets transferred at death. The legislation includes an exemption from carryover basis for capital gains of $1.3 million (and an additional $3 million for a surviving spouse). However, the estate tax provision in EGTRRA automatically sunsets December 31, 2010. Thus, the estate and gift tax will be reinstated in 2011 as it existed before EGTRRA. In the 109th Congress, H.R. 8, which passed the House on April 13, 2005 (and it's Senate companion S. 420), would eliminate the sunset provision in EGTRRA, thus making repeal of the estate tax permanent. Repeal of the sunset (as in H.R. 8) would retain the EGTRRA changes to the taxation of capital gains of inherited assets and the gift tax. Supporters of the estate and gift tax cite its contribution to progressivity in the tax system and to the need for a tax due to the forgiveness of capital gains taxes on appreciated assets held until death. (The estate tax accounts for 1.2% of federal tax receipts.) Arguments are also made that inheritances represent a windfall to heirs that are more appropriate sources of tax revenue than income earned through work and effort. Critics of the estate tax argue that it reduces savings and makes it difficult to pass on family businesses and farms. Critics also argue that death is not an appropriate time to impose a tax; that much wealth has already been taxed through income taxes; and that complexity of the tax imposes administrative and compliance burdens that undermine the progressivity of the tax. The analysis in this study suggests that the estate tax is highly progressive, although that progressivity is somewhat undermined by avoidance mechanisms. Neither economic theory nor empirical evidence indicate that the estate tax is likely to have much effect on savings. Although some family businesses and farms are burdened by the tax, the estate tax applies to only a tiny fraction (approximately 3% or 4 %) of businesses that have, in most cases, sufficient liquid assets to pay the tax. Only a small percentage of estate tax revenues are derived from family businesses. Even though there are many estate tax avoidance techniques, it also is possible to reform the tax and reduce these complexities as an alternative to eliminating the tax. Thus, the evaluation of the estate tax may largely turn on the general appropriateness of such a revenue source and its interaction with incentives for charitable giving, state estate taxes, and capital gains and other income taxes. A number of alternative revisions are discussed including past proposals to reduce tax rates and exemptions as well as proposals to reduce the opportunities for tax avoidance and broaden the estate and gift tax base. This report will be updated as legislative events warrant.
Get it at http://www.nationalaglawcenter.org/assets/crs/RL30600.pdf
About 40 protesters held a candlelight vigil outside the Seattle University administration building Thursday, saying the scheduled closure of a campus nursing home contradicts the school's core values. Forcing 135 residents to find a new home does not uphold the Jesuit tradition of service to others and social justice, said sophomore Matt Salazar, who organized the demonstration attended by students, staff and faculty. University officials said the Bessie Burton Sullivan Skilled Nursing Residence -- a three-story building with 60,000 square feet -- needs to be converted into dorm rooms, classrooms, science labs and faculty offices for an institution with a growing enrollment and space demands. "They say they made this decision for the good of the students," said Salazar, 19, the student campus minister for community service. "I don't want an elderly person kicked out of their home for my benefit." The university's decision turned on a basic question, senior university Vice President Timothy Leary said: "Does it make sense to run and operate a skilled nursing facility given the pressing needs" of space on campus and the university's educational mission? When the nursing home opened in 1990, the university had 4,600 students. Now there are 7,200, and the average student age has dropped from 27 to 21, which has increased the demand for dorm rooms and other spaces, Leary said.
A new issue of the National Bureau of Economic Research's Bulletin on Aging and Health has been released. The issue contains the following articles:
• The Growth in the Social Security Disability Insurance Rolls
• Differential Mortality, Uncertain Medical Expenditures, and the Savings Decisions of the Elderly
• Using Genetic Markers to Measure the Effect of Health on Education.
Almost 4,900 new staff - including 1,101 new nurses - have been hired since 2004 to provide quality care to residents as part of the McGuinty government's plan to improve the quality of life at long-term care homes, Health and Long-Term Care Minister George Smitherman nnounced today. The McGuinty government is working to ensure our families and loved ones living in long-term care homes are cared for safely and with dignity," Smitherman said. "Having more staff in homes will give families and friendsthe confidence that residents are carefully looked after and that they are enjoying a higher standard of care." Since 2003, the McGuinty government has increased funding to the long-term care home sector by $740 million on an annual basis. This has allowed the sector to increase the size of its workforce by 4,891, from 34,068 in January 2004 to 38,960 today. This includes 1,101 new nurses. The Minister made the announcement on the same day that legislativehearings began on the proposed Long-Term Care Homes Act, 2006. The legislationwas introduced last October and, if passed, would strengthen enforcement and improve care and accountability in the long-term care home sector.
Source: CNW Group/McGinty press release
Thursday, January 18, 2007
Art Buchwald, who satirized the follies of the rich, the famous and the powerful for half a century as the most widely read newspaper humorist of his time, died Wednesday night in Washington. He was 81. The cause was kidney failure, his son, Joel, said. Mr. Buchwald, long a pillar of Washington life, died at his son’s home, where he had been living for most of the last eight years. Mr. Buchwald’s syndicated column was a staple for a generation or more of newspaper readers, not least the politicians and government grandees he lampooned so regularly. His life was a rich tale of gumption, heartbreak and humor, with chapters in Paris, Washington and points around the globe. But perhaps no year of his life was as remarkable as the last. It became something of an extended curtain call. Last February doctors told him he had only a few weeks to live. “I decided to move into a hospice and go quietly into the night,” he wrote three months later. “For reasons that even the doctors can’t explain, my kidneys kept working.” Refusing dialysis, he continued to write his column, reflecting on his mortality while keeping his humor even as he lost a leg. He spent the summer on Martha’s Vineyard, published a book, “Too Soon to Say Goodbye,” in the fall and attended a memorial for an old friend, the reporter R.W. Apple Jr. of The New York Times. He gave interviews and looked on as his life was celebrated. “The French ambassador gave me the literary equivalent of the Legion of Honor,” he wrote. “The National Hospice Association made me man of the year. I never realized dying was so much fun.” Once described as a “Will Rogers with chutzpah,” Mr. Buchwald found enthusiastic readerships on both sides of the Atlantic. Early on he became nearly everyone’s favorite American in Paris for his satirical column in the European edition of The New York Herald Tribune. When he returned from overseas to write a new column, from Washington, he became even more popular. At its peak it appeared in some 500 newspapers. He delighted in stirring the pot — never maliciously, always vigorously. The world was mad (or at least a little nutty), he said, and all he was doing was recording it. He did it so well that he was awarded a Pulitzer Prize for commentary in 1982.
After one year's experience with Medicare Part D, many people remain confused and frustrated by the complexity and limitations of the benefit. Problems are difficult to resolve because of system failures, complicated data-sharing requirements among multiple entities, lack of useful and standardized information about plan benefits and appeal processes, and regulatory limitations that are more stringent than required by law. The Center for Medicare Advocacy has prepared a Status Report based on the experiences of advocates and beneficiaries over the first year of Part D. The beneficiary stories in the Report are illustrative of the many beneficiaries who are experiencing problems and high costs due, in large part, to the lack of uniformity in Medicare Part D. The stories focus on particular aspects of Part D implementation - the failure of systems to ensure that low-income beneficiaries are enrolled in plans and receive their subsidies, the lack of useful information about benefit limitations to help beneficiaries plan, the failure of the system for withholding plan premiums from beneficiaries' Social Security checks, and the lack of uniform policies and procedures for seeking exceptions to formulary limitations. Reflection on the issues underlying these problems confirms that beneficiaries would be better off with a redesigned benefit that is standardized, available throughout the country, and administered through the traditional Medicare program. Such a system would be more valuable for more beneficiaries and more cost-effective for taxpayers.
A new Pennsylvania state law that takes effect Jan. 29 is expected to protect patients and health care providers from problems related to living wills. Living wills, which are called "advance directives" under the law, have caused many problems in Pennsylvania. For example, the terminally ill resident of a nursing home might have a living will that specifies he doesn't want last-ditch life-saving measures if there is no chance of recovery. But a medical emergency might send him to the hospital. The hospital might disregard the living will, perhaps believing that it didn't apply outside the nursing home, or fearing that it could be sued for denying treatment.
The patient might end up on life-support equipment against his and his family's wishes, wracking up large medical bills for pointless treatment. At the other extreme, someone with a good chance of recovery might be denied life-saving measures because caregivers knew he had a living will and assumed it included "do-not-resuscitate" instructions. Advance directives are commonly used to inform health care providers that someone doesn't want treatment such as breathing help with a ventilator or a feeding tube if they have no chance of getting well. Health care providers commonly turn to such directives with terminally ill patients who are unconscious or mentally incompetent. These directives also can be used to inform medical professionals that a person wants any treatments that might prolong life. The issue received national attention when courts and Congress became involved in the decision on whether Terri Schiavo, a brain-dead Florida woman, should have her feeding tube removed.
Wednesday, January 17, 2007
NAELA, AARP and GRAND Magazine are proud to announce the first ever NAELA Elder Leadership Award! The award will be presented during the Opening Remarks on Thursday, May 3, 2007 at the 2007 NAELA Symposium. The award ceremony will include a professional video presentation highlighting the recipient's life and work for the benefit of other people; and will include a monetary contribution in the recipient's name to a charitable organization with whom the award recipient has worked closely. The award is designed to encourage and promote activism and involvement by elders for the betterment of the lives of others. NAELA Members can nominate a person age 65 or older who has made a significant contribution to other people on a statewide or national level.
Nomination forms are due by February 28, 2007. You may submit your nomination via the online registration form or you may print out the form and mail it to Ann Krauss at NAELA, 1604 N. Country Club Road, Tucson, AZ 85716. If you prefer, you may also fax it to 520.325.7925.
Please take a moment to nominate a deserving person!
Mary F. Radford has joined the faculty at Phoenix School of Law as a Visiting Professor for the Spring and Fall semesters of 2007. She will teach Wills & Trusts and Estate Planning. Radford is a full-time faculty member at Georgia State University College of Law in Atlanta, where she has taught since 1984. In 1990-91, she worked as a Supreme Court Fellow for Chief Justice William H. Rehnquist. Prior to teaching, Radford practiced as an associate at the Atlanta firm of Hansell & Post. She earned her J.D. from Emory University in 1981, and has also taught English and French at the high school level. Among her many honors, Radford is an Academic Fellow, Regent, and Executive Committee Member of the American College of Trust & Estate Counsel and in 2006, was elected as an Academic Member of the American Law Institute. She currently serves as the Reporter for the Georgia Trust Code Revision Committee. The author of several publications and law review articles, Radford is a frequent presenter on estate planning, guardianship and elder law topics at local, national and international seminars. She has been listed for three years by Atlanta Magazine of one of Georgia’s “Top 50 Female Lawyers” and was listed in 2006 among “Georgia’s Top 100 Lawyers.”
Tuesday, January 16, 2007
Many rural hospitals and nursing homes would get fewer federal dollars under a proposal to save Medicaid almost $4 billion over the next five years. The change would have "a significant economic impact on a substantial number" of health care providers, the Bush administration acknowledges.At issue are financing arrangements between states and local governments. These deals tend to increase Washington's share of spending in Medicaid, the joint state-federal program covering 55 million poor and disabled people, even when a state's share is unchanged or drops. The federal share of the program ranges from 50 percent to 76 percent, depending upon the state. Poor states receive a greater federal share. In many states, financing arrangements between health care providers and the state result in the federal government paying more than the law says it should. Dennis Smith, director of the federal Center for Medicaid and State Operations, said the proposed rule made public late Friday would put a crimp on that practice."This is about the match rate, and states have demonstrated they're willing to fund their share of the program," Smith said in an interview Saturday. "It's just that for many years previous to us, they were not paying their share."The Kaiser Family Foundation, which conducts health care research, said some of these arrangements have helped states maintain important services, such as nursing home care, during tough economic times.
As many as 20,000 nursing home residents, the vast majority of whom may now be deceased, will be reimbursed through a federal court settlement approved by Hon. John Curtin. The settlement, reached Dec. 28, resolves Conrad v. Perales, a class action filed in 1992 on behalf of thousands of New York nursing home residents. Curtin, senior judge of the U.S. District Court for the Western District of New York, approved creation of an $11 million fund to reimburse residents who were defrauded by having to pay Medicaid co-pays even though they were eligible for Medicare. The thing about this case is, the state was an active participant in the fraud. In fact, the author of the fraud was a state program that (allowed for) the double billing and collection of funds of poor people," said lawyer Henry Killeen III of Killeen & Killeen, lead litigation counsel for the plaintiffs, referring to the Medicare Optimization Program (MOP II) created by the New York State Health Department in 1989. Because the state Medicaid program, which primarily provides custodial care, is considered the "payer of last resort," nursing home residents must forward all their income, including Social Security benefits and pensions, to the facility they live at. However, seniors who qualify for Medicare, which usually involves specific medical care, can keep their income, and Medicare will cover their nursing care in full. MOP II required nursing homes to bill both Medicaid and Medicare on behalf of nursing home residents. Homes would keep the proceeds from whichever program paid higher benefits -- usually Medicaid -- and send the remaining benefits, usually Medicare, to the state. Federal law, however, requires nursing homes to accept Medicare reimbursement in full satisfaction of a patient's covered services. It is believed that thousands of New Yorkers in nursing homes may have been affected. The double-billing was discovered by Anthony Szczygiel, an attorney at Legal Services for the Elderly, Disabled or Disadvantaged of Western New York Inc. who is also a professor at the University at Buffalo Law School, where he heads the elder law clinic. Szczygiel filed a class-action lawsuit against the New York State Health Department in 1992 contending that the state did not abide by federal requirements to refund the victims.
Monday, January 15, 2007
Families USA study shows VA drug prices consistently and significantly lower than Part D plans' pricing
"Families USA analyzed the drug prices that Part D plans charge for the 20 drugs most frequently prescribed to seniors. We examined prices for each of the plans offered by the five largest Part D insurers. Combined, these five insurers serve about two-thirds of all Part D beneficiaries (Table 1). Because these companies have, by far, the largest share of the total market for Part D plans, they have the greatest ability among all the private Part D insurers to secure the best drug prices. Yet, as our analysis demonstrates, their prices are much higher than those obtained by the Department of Veterans Affairs (VA), which negotiates for low drug prices on behalf of America’s veterans.
We found that for all of the top 20 drugs prescribed to seniors, VA prices are substantially lower than the lowest prices charged by the largest Part D insurers. The median difference was 58 percent. In other words, for half of the 20 drugs, the lowest price charged by the largest Part D insurers is at least 58 percent higher. What’s more, when we examined the full range of Part D plan prices, we discovered that the highest plan prices are considerably higher than their lowest prices.
In addition, to assess the effect that meaningful price negotiation would have on R&D, we analyzed the most recent annual filings to the Securities and Exchange Commission (SEC) by the seven largest U.S.-based pharmaceutical manufacturers. These filings report each company’s R&D expenditures and profits, as well as what each company spends on marketing, advertising, and administration. We found that, on average, these drug companies spent more than twice as much on marketing, advertising, and administration as they did on R&D. Moreover, most of these drug companies retained profits that were larger than their R&D expenditures.Key Findings from a FamiliesUSA study:
The lowest Part D plan prices are significantly higher than the prices obtained by the VA.
* For each of the top 20 drugs prescribed to seniors, the lowest price charged by any of the top Part D insurers is higher than the lowest price secured by the VA.
* Among those top 20 drugs, the median difference between the lowest Part D plan price and the lowest VA price is 58 percent.
The price differential between the lowest VA-negotiated price and the lowest price available from a Part D private plan is often substantial. For example:
* For Zocor (20 mg), a lipid-lowering agent, the lowest VA price for a year’s treatment is $127.44, while the lowest Part D plan price is $1,485.96—a difference of $1,358.52, or 1,066 percent.
* For Protonix (40 mg), a gastrointestinal agent, the lowest VA price for a year’s treatment is $214.52, while the lowest Part D plan price is $1,148.40—a difference of $933.88, or 435 percent.
* For Fosamax (70 mg), an osteoporosis treatment, the lowest VA price for a year’s treatment is $250.32, while the lowest Part D plan price is $763.56—a difference of 513.24, or 205 percent.
* For Toprol XL (100 mg), a beta blocker, the lowest VA price for a year’s treatment is $250.06, while the lowest Part D plan price is $395.52—a difference of $145.46 or 58 percent.
* For Celebrex (200 mg), an anti-inflammatory, the lowest VA price for a year’s treatment is $632.09, while the lowest Part D plan price is $946.44—a difference of $314.35, or 50 percent.
The median difference between the highest Part D plan price and the VA price is 101 percent. In other words, for half of the 20 drugs, the highest price charged by a large Part D plan is at least twice as high as the lowest price secured by the VA. Many Medicare beneficiaries are in drug plans in which they pay even higher prices.
Each of the seven largest U.S. publicly traded pharmaceutical companies spent substantially more on marketing, advertising, and administration than it spent on research and development (R&D).
* In 2005, five of the seven companies spent at least twice as much on marketing, advertising, and administration as they did on R&D.
* On average, marketing, advertising, and administration comprised 32.0 percent of company revenues, while R&D represented 13.9 percent of company revenues.
Profits exceeded R&D expenditures for most of the large pharmaceutical companies.
* Five of the seven companies generated more in profits than they spent on R&D in 2005.
* On average, companies reported 17.4 percent of revenue as profits, whereas spending on R&D represented 13.9 percent of company revenues."
Does surfing the Web exhaust — and even exasperate — older people? The backers of Cranky.com are betting on it. Cranky is a specialty search engine designed to please aging baby boomers by processing every request from the perspective of someone who is at least 50 years old. This steadily growing demographic often feels overwhelmed using high-powered search engines from the likes of Google Inc. and Yahoo Inc. because they spew out more results than older eyes care to see, said Jeff Taylor, the Cranky mastermind who struck it rich as the founder of online employment site Monster.com. cc"Our research found that people 50 and over are confused about searching on the Web," said Taylor, who runs Eons Inc., a Boston-based start-up devoted to creating products aimed at the graying baby-boom generation born from 1946 to 1964. "It's hard for them to understand all the results." Launched this week, Cranky is trying to simplify things by showing just four websites in the nonadvertising section of each results page and making the sparser listings more relevant to its target audience. Google and Yahoo usually list at least 10 sites per results page.
Ed: As a graying but blogging, html coding, domain name owning, website managing 'Net fiend webaholic, I have some doubts about the research underlying the site. How old are you anyway, Jeff Taylor? Do you remember Lynx???? I do.
More than two-thirds of older patients report sleep problems, but doctors rarely note these complaints in the patients' charts, a Northwestern University study finds. The study, published in a recent issue of the American Journal of Geriatric Psychiatry, included 1,503 patients aged 60 and older who visited their primary-care doctors. After the visits, social workers surveyed the patients about sleep problems. The social workers learned that 69 percent of the patients had at least one sleep complaint, and 40 percent had two or more. Forty-five percent of the patients said they had "difficulty falling asleep, staying asleep, or being able to sleep.'' Despite the high rate of sleep complaints among the patients, a sleep complaint was only reported by the doctor in the patient's chart 19 percent of the time, even when the patient indicated sleep problems in all five sleep questions on the survey. This is important, since previous research has linked sleep disorders in the elderly to poorer mental and physical health and quality of life. "A doctor may not think that it's very important to ask the patient about sleep. We (the researchers) hypothesize that doctors think that sleep problems are a normal part of aging, and there's not much they can do about it,'' study author Kathryn Reid, a research assistant professor of neurology at Northwestern's Feinberg School of Medicine, said in a prepared statement.
Source: Asbury Park Press, http://www.app.com/apps/pbcs.dll/article?AID=/20070112/LIFE11/70112010/1006/LIFE
Sunday, January 14, 2007
With public hearings on Bill 140 set to begin in Ontario, a major association is warning that the proposed act as currently drafted will result in a reduction in the level of care and quality of life of long term care residents. "We are deeply concerned because, in many respects, this proposed legislation is seriously flawed," said Donna Rubin, CEO of the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). "Unless changed, this act will negatively affect the lives of seniors in long term care for decades to come." Rubin is available to discuss Bill 140. She will also be presenting at the Jan. 17 hearing in Toronto at 10:15 a.m. Bill 140 proposes a significant increase in regulation. While OANHSS supports measures to enhance standards and ensure full accountability, this legislation is so excessively onerous that homes will be forced to shift already scarce resources to meeting new administrative demands. With more time having to be spent on compliance and documentation, there will be even less time available for direct care and services. OANHSS is also concerned that Bill 140 will lead to an erosion of the not-for-profit sector, resulting in fewer choices for consumers, seniors and their families.
A class action lawsuit (Case #07CC00005), against the beleaguered residential elder care operator Sunwest Management (see listing of Sunwest California facilities at end of releases), was filed yesterday in Orange County Superior Court, on behalf of Sophie Bury by and through her Attorney in Fact, Patricia Bury, on her behalf and on behalf of all California citizens who resided in, or are residing in, a California Sunwest facilites from Jan. 15, 2003 through Jan. 15, 2007. The complaint alleges that Sunwest Management, Inc., its directors, and the approximately 16 residential elder care facilities in the state of California that it owns, operates or manages, fail to comply with applicable laws and regulations governing the operation of residential care facilities for the elderly, resulting in the defendants receiving multiple citations of deficiencies from the California Department of Social Services. "We believe Paragon Gardens is typical of a Sunwest facility," says Long Beach, Calif., plaintiff attorney Stephen Garcia of The Garcia Law Firm. "Since June 2005, Paragon Gardens earned 57 notices of deficiencies, all of which were Type A violations, considered to be the most serious. On its web site Sunwest Management claims to operate 150 'communities' nationwide. How many Paragon Gardens do they have?" The lawsuit alleges that Sunwest and its facilities deliberately understaff its "communities" by forcing each facility to operate under a
budget, approved and directed by Sunwest Management and the directors of the individual facilities, that would increase business profits by charging for services that were not provided, such as adequately staffing the residential care facility as it advertises that it does.