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6B Daily News – Tuesday, November 13, 2012 By Marjie Lundstrom The Sacramento Bee (MCT) SACRAMENTO — Until he died last month at age 82, Don Esco of Cameron Park, Calif., had his own way of measuring the passage of time: by the years, months and days since the death of his wife, Johnnie, after a short stay at a Placerville nursing home. It was never enough, he always said, to settle a civil lawsuit with the El Dorado Care Center in Placerville, which he blamed for his 77-year- old wife's death in March 2008. No, he said, it was never about the money. Johnnie's death, he maintained, was a crimi- nal matter — and the state of California agreed. On Nov. 1 — four years, seven months and 24 days after Johnnie Esco died — one of two nurses charged with felony elder abuse in con- nection with her death pleaded no contest to the charge. Rebecca LeAn Smith, 39, also agreed to cooperate with prosecu- tors in the ongoing crimi- nal case against her for- mer nursing supervisor, Donna Darlene Palmer. While Don Esco did not live long enough to witness that development in El Dorado Superior Court, his persistence has made its mark in Califor- nia. moves forward — and another high-profile pros- ecution of nursing home staff continues in Kern County — representatives of Attorney General Kamala D. Harris told the Sacramento Bee that the state will begin aggres- sively building more criminal cases statewide. Harris' office is form- ing three specialized teams — one in Sacra- As the Esco case mento, two in Southern California — to pursue criminal charges against nursing home administra- tors and employees where deep, systemic problems are suspected. "Elder abuse is a par- ticularly tragic crime because it targets a beloved population — our aunts and uncles, our par- ents — at what can be a vulnerable time in their lives," said Harris in a prepared statement, refer- ring to these crimes as "serious and often hid- den." "We know abuse of our elders is becoming more pervasive, so we must become more resolute in our protection of them." In California and else- where, criminal prosecu- tions of nursing home workers or their employ- ers have been rare, with allegations of abuse or neglect frequently han- dled in the civil courts. Harris' move could potentially reverse a steady decline in recent years in the state's crimi- nal actions involving elder abuse. In the past decade, criminal elder- abuse complaints filed by California's attorney gen- eral dropped from 112 in fiscal 2002-03 to 60 in 2011-12, state figures show. Under Harris' plan, each of the three teams will have an attorney, a nurse and an auditor _ plus support from a med- ical person with a special- ty in geriatrics. The teams will develop criminal cases of "systemic abuse" in facilities where patients' daily activities are overseen, according to Mark Zahner, chief of prosecutions for the AG's Bureau of Medi-Cal Fraud and Elder Abuse. Zahner stressed prose- cutors aren't looking for isolated incidents where a In California, stepped-up efforts to tackle elder abuse low-level employee trips up on the job. "People make mis- takes, people are human beings," he said. "We're really after the bad apples out there who are more concerned with how many boats and yachts and mansions they have rather than caring for the people who are in their facilities. "We're out for the peo- ple who put profit ahead of the care that they're giving," he said. But some are skeptical that the attorney general's office will deliver _ par- ticularly in prosecuting corporate owners. Lesley Ann Clement, the Sacra- mento attorney who sued Horizon West on behalf of the Esco family, said she was stunned the state did not go after the chain's owners. are feeble or already dead. Many defendants come well-represented legally, with a team of experi- enced attorneys bankrolled by a corpora- tion. And then there are the most fundamental ques- tions: Can the state prove beyond a reasonable doubt that an administra- tor or worker intended to harm the patient? And who, out of the patient's many caregivers, should be singled out for prose- cution? "The question is why? Why did these things hap- pen?" said Clement, who specializes in nursing home cases. "The answer is, there's not enough staff, and that happens at the corporate level." When asked why Hori- zon West management was not criminally charged, AG spokesman Lynda Gledhill said inves- tigators determined that the corporate owners were "very cooperative and took immediate action when the situation came to light." ly find that medical records are incomplete, and death certificates are signed by the same people who are under investiga- tion. Key witnesses often officials acknowledge that criminal cases will not be easy. Elder-abuse prose- cutions are expensive and labor-intensive, they say. Voluminous medical records must be exam- ined, and expert testimo- ny gathered. Investigators frequent- Zahner and other state "When you're in a nursing home, where you have all these different shifts and different people taking over care at differ- ent times — who did what when is one of the prob- lems (for prosecutors,)" said Prescott Cole, senior staff attorney for the San Francisco-based Califor- nia Advocates for Nursing Home Reform. she negotiated a plea because she was raised to take responsibility for her actions. She said she believed that Johnnie Esco's care could have been better and that she is deeply sorry. have been more that was done at the time," she said tearfully after court Nov. 1. "My heart aches." Palmer's attorney, "I wish there would attorneys also can file criminal charges in nurs- ing home cases, most in California do not, said Cole. That leaves the task largely to the attorney general's office, which frequently is "outgunned" in court by deep corporate pockets within the nurs- ing home industry, he said. While local district tainly believes there is no place for abuse and neglect in long-term care," he said. However, he said, if a nursing home owner is convicted criminally of elder abuse — even if it's an isolated act — the law requires that the facility be excluded from receiv- ing Medicare or Medicaid funding. "It's a real death sentence," he said. Mark Reagan, attorney for the California Associ- ation of Health Facilities, said that industry support for the attorney general's initiative "depends on how well they handle prosecutorial discretion." With so much at stake for workers and corporate owners — an entire chain of nursing homes could be forced out of business with a single conviction —state prosecutors must sort out which cases should be handled admin- istratively, civilly or crim- inally, Reagan said. "This organization cer- attorney general contend- ed that Palmer and Smith provided "substandard" care and failed to ade- quately supervise staff, contributing to Johnnie Esco's deterioration and death. Both nurses helped oversee the woman's 13 days of care at the El Dorado Care Center in Placerville, a skilled nurs- ing facility owned at the time by Horizon West Healthcare Inc. of Rock- lin. Last year, Horizon West Healthcare Inc. sold its 27 nursing homes, including the El Dorado Care Center, to a San Marcos-based chain. The Placerville facility since has been renamed. Smith, who lives in Louisiana, told The Bee In the Esco case, the Patrick K. Hanly, said he was surprised by Smith's plea because there is "no evidence" to support the charges against the nurs- es. Hanly has portrayed the attorney general's office in court as grand- standing, filing charges only after the case was detailed in The Bee. The AG's office reopened its criminal investigation last year after The Bee chronicled the Escos' story in a series exploring the problem of falsified records in nurs- ing homes. The Esco fam- ily's civil lawsuit alleged that Johnnie's medical chart was sloppy, showed evidence of being altered and failed to accurately reflect her condition. Don Esco, who enlist- ed in the Army Air Corps at age 15, will be buried this month alongside his beloved wife at Arlington National Cemetery. They had been married for nearly 61 years. So concerned were prosecutors about Don Esco's failing health that he was called to testify in August to preserve his memories for the record. He died Oct. 8 in Sacramento. "I've got one purpose in life," he told The Bee last year, "and that's to do what I can to eliminate the pain and suffering in nurs- ing homes and make sure the guilty parties are pun- ished." Judge reduces what 'Girls Gone Wild' creator owes LOS ANGELES (AP) — A judge has cut by more than half the $40 million jury verdict that casino mogul Steve Wynn was recently awarded against ''Girls Gone Wild'' founder Joe Francis. Los Angeles Superior Court Judge Joanne O'Donnell issued the ruling Friday cutting the award by $21 million. Her ruling eliminates $20 million in punitive damages the jury granted Wynn and $1 mil- lion they said he deserved because of comments Fran- cis made on ''Good Morn- ing America.'' The ruling only affects damages awarded in the case and preserves the jury's determination that Francis defamed Wynn on three separate occasions. Francis vowed to appeal the remainder of the verdict. ''Judge O'Donnell com- mitted a judicial error by allowing this case to even proceed to a trial and she knows it,'' Francis said. ''This is only the first step of her back peddling and unwinding her illegal actions in order to try to keep her job as a judge.'' have argued the statements on ABC's national morning show were not part of the initial case and shouldn't be included in the judgment. The trial, which ended in September, centered on Francis' claims that he was told Wynn had threat- ened to hit him in the head with a shovel and have him buried in the desert. Wynn denied making the threats and claimed they damaged his reputation and put his casino license at risk. Francis' lawyers also DONATE YOUR VACATION newspaper dollars to the Newspaper In Education Program Support our classrooms, keep kids reading. HELP OUR CHILDREN DAILYNEWS For more details call Circulation Department (530) 527-2151 RED BLUFF TEHAMACOUNTY T H E V O I C E O F T E H A M A C O U N T Y S I N C E 1 8 8 5 PHONE: (530) 527-2151 FAX: (530) 527-5774 545 Diamond Avenue • P.O. Box 220 • Red Bluff, CA 96080