Coastal Post Online


March, 2004

"Operation Guardians" Prompts Better
Care for Elderly and Dependent Adults
By California Attorney General Bill Lockyer

In April 2000 I established Operation Guardians as a pre-emptive, pro-active program to prevent abuse and neglect of the elderly and dependent adults in our state's nursing homes. This program uses multi-agency teams to conduct unannounced inspections of facilities and identify problems that threaten the dignity, safety, welfare and quality-of-life of the residents.

Between April 2001 and March 2003, Operation Guardians conducted 150 surprise inspections of California skilled nursing homes, generating corrections of dangerous conditions and improving the quality of care and living conditions for the facilities' residents.

Operation Guardians is helping ensure that the 250,000 elderly and dependent adults who reside in the state's 1,400 skilled nursing homes are receiving the care they deserve. This program is preventing loss, injury and death by identifying health and fire hazards, theft of patients' trust account funds and failures to provide adequate medical services to these vulnerable citizens before they can escalate into life-threatening problems.

Operation Guardians operates and inspected facilities in 16 counties: Alameda, Contra Costa, Fresno, Humboldt, Los Angeles, Monterey, Napa, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, Santa Barbara, Santa Clara, Sonoma and Ventura. Additional inspections were conducted at the request of three counties: Marin, San Mateo and Yolo.

Most of the nursing homes inspected during the past two years quickly responded by making improvements in the facilities and the medical and health care provided. The most prevalent problems identified were: failure to meet the state's minimum staffing requirements of 3.2 nursing care hours per day per resident, ensure that nurse assistants possess valid certification, document tuberculosis tests of employees and prevent and document the loss of residents' property.

The inspections showed that performance levels ranged from near compliance with federal and state standards of care to situations which required referrals to law enforcement, regulatory or licensing agencies. The inspections resulted in two felony convictions. In one, a licensed vocational nurse was convicted of stealing narcotic pain medication intended for residents in an Oxnard facility. In another, an administrator-in-training at a Napa facility was sentenced to three years in state prison for stealing $49,000 from facility residents and their families, and using threats and intimidation to discourage them from reporting the theft.

Although the goal of Operation Guardians is to prevent injury by identifying even the smallest of problems that, if left unchecked, could grow into dangerous situations for residents, we also are there to root out criminal activities that then can be prosecuted.

Headed by my Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA), Operation Guardians includes local elder abuse ombudsmen, fire departments, prosecutors, police and the University of Southern California School of Medicine. The inspections complement regular inspections conducted by the Department of Health Services.

Since I began my first term as Attorney General in 1999, my BMFEA has increased criminal prosecutions of elder abuse in the state's skilled nursing homes by 749 percent, and convictions by 574 percent. The "Operation Guardians, 2001-02 and 2002-03" report may be viewed at


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