One City Built to Last

abuse did occur,” Arragg said. “It really
is an art that litigators have to master.”
“In medical malpractice, lawsuits
hinge on four elements: the duty of the
medical professional, a breach of that
duty, causation and damages These
elements only provide the basis for an
elder abuse case. To prove elder abuse,
a plaintiff must be able to prove reckless
neglect and abandonment of the patient,”
Arragg said.
That’s tough and it is also why a larger
percentage of elder abuse claims are
being settled in favor of the defendant.
“The defendant can prove that they
gave medication or provided treatment
at the appropriate times. They can easily
prove that 24-hour care was given
and that the patient saw the doctor,”
Arragg said.
Much of the challenge surrounding
elder abuse is represented in the unrealistic
expectations of family members.
Skilled nursing facilities are not required
to provide the one-on-one care
that is desired by family members. Yet,
because these often become “home” for
so many elder patients, the desire for
more attention often conflicts with the
financial realities governing these facilities.
Many elderly patients come in with
Medicaid as their only source for payment.
In California, dependent upon
the size of the skilled nursing facility,
that averages $180 per day to cover
medication, 24-hour nursing care,
meals and a room. It represents a significant
disconnect that Arragg sees
reaching a crisis point, not only is our
population living longer, but also as
more and more baby boomers enter
retirement and begin to experience
the medical complications that often
accompany aging.
“That is pretty low reimbursement
for a facility to employ a registered
nurse that costs $40 an hour,” she
said. “Can these facilities afford to
provide one-on-one care? Absolutely
not. It is a sad struggle, but the reality
is that there simply is not enough
time, not enough money, not enough
resources.”
This is the reason she focuses on
her out-of-court consulting services
aimed at helping long-term care facilities,
assisted living homes and skilled
nursing facilities do more with the resources
they have and to stay ahead
of regulatory changes. She is also a
huge proponent of training registered
nurses to specialize in long-term care.
Arragg knows there is more work to
do. Yet, in the 15 years since she consulted
on that first case, she has consulted
on thousands of cases across
the nation that have had great effectiveness,
by helping to clarify whether
or nor elder abuse had occurred.
“I feel as if my greatest success has
been my ability to educate attorneys
about the continuum of health care
and how this impacts legal matters –
particularly in the unique setting of
long-term care,” Arragg emphasized.
SEA & Associates Medical Legal
Consulting
P.O. Box 3222
Ventura, CA 93006-3222
www.sealegalnurse.com
THE SUIT MAGAZINE p.83