A whistle blower is usually thought of as someone inside the system, but this is not necessarily so. Fraud involving failures in care is most commonly exposed by members of the community, often patients or their relatives. This differs from financial fraud where the whistle blowers are internal. When families and their relatives become aware of deficiencies in care they have been strongly motivated to do something about it. They are not constrained by loyalty to professional groups and their careers are not at risk when they speak out. Insiders risk losing their livelihood and their reputations. The problems for patients and their families relate to credibility. They are seen to be uninformed and biased by their experiences.
The misuse of patients in Tenet/NME's hospitals was exposed when the parents of a teenager who was kidnapped by a hospital complained to police. Unusually the policeman believed the patient rather than the hospital. His efforts led to publicity and then a senate inquiry. Hundreds of past patients then came forward to speak publicly at the inquiry describing how they had been misinformed and their trust abused. They described their suffering and misery as they were misused for profit in hospitals owned by Tenet/NME and other corporate chains including HCA and Charter Hospitals.
In aged care it has also been members of the community who have been the driving force. Family members of misused patients have looked around them. They have done something about the appalling conditions they found in corporate owned nursing homes. Advocacy groups and associations of seniors have now been formed in most states. They have been active in prosecuting poor homes and in pressing politicians.
Some of these community groups reflect the uncertainty which older members of the public feel when dealing with "experts" and those who wield power. They have consequently adopted a relatively low key approach and have taken a cooperative stance with politicians and even with the corporate chains. They have been discomforted by aggression and have condemned aggressive criticism of care. Some have even accepted funding for their activities from corporate chains. This is a step which compromises their integrity. Groups like this have not been effective. Some even become advocates for the corporate system. A number are formed as or become front organisations funded by the corporations to create the illusion of community support.
Hard evidence and effective action have come from those individuals and groups that have been aggressive and confrontational. These groups have collected information using hidden video cameras. They have targeted poor nursing homes and encouraged the relatives of misused patients to take to the courts. Lawyers have taken up their cases. They have shown that many corporate nursing homes deliberately understaff and permit the neglect of the elderly to increase their profits. Juries are horrified by the disclosures and award massive punitive penalties. This strategy is the only strategy which has exerted any restraint on the corporate system.
Ila Swan is one of the most aggressive and
confrontational of these. She has been the most successful and
effective of them all.
Ila Swan is an ordinary citizen but a very remarkable one. Her persistence and dedication have resulted in the exposure of serious problems in nursing homes across the USA. She is totally dedicated and uncompromising.
Ila fell foul of the aged care system when her mother was mistreated and neglected in a corporate nursing home. One day she pulled back the sheets to see what her mother was complaining about. She found herself looking at her mothers hip joint down a huge cavity caked in dried faeces. No one had told her that her mother had developed a pressure sore, let alone something as dreadful as this. She looked around her and noticed what was happening to others in the home.
When Ila took her concerns to the authorities responsible for monitoring standards of care in nursing homes she met a brick wall. Ila set about learning all she could about care of the aged. She visited homes around California examining the care given to the residents. She lodged hundreds of complaints with regulatory authorities. Most were ignored. Ila sought out the reasons. Her inquiries revealed the close personal and financial links between politicians and nursing home chains.
Ila took out thousands of death certificates and analysed them. She concluded that thousands were suffering needlessly and dying prematurely. She also accessed public records to identify corporate donations to politicians.
Ila sent collections of death certificates, graphic photographs and footage from hidden video cameras to 200 senior US political figures including the president. Not one responded, and she was referred to as a 'zealous pervert'. A copy of Ila's material had been given to a group who had previously exposed fraud and abuse of process in the Department of Defense.
Ila, her attorneys and new friends hired someone from vital records who knew how to access computerized federal codes. They went back 5 years electronically and got 26,000 death certificates. They took 23,000 of these to Senator Grassley whom Ila then met. The FBI and the GAO came to Ila's home, went through her records, then began their 9 months investigation into the care given in California nursing homes. The investigation culminated with the release of the GAO Report stating: 30% of California Nursing Homes were causing death or serious injury to their patients and only 2% of the nursing homes were providing care with minimal or no deficiencies.
This confirmed Ila's findings and the report prompted Senator Grassley to hold Congressional Hearings.
Ila has written vast numbers of blunt plain language accusatory letters to authorities and to politicians. She supplied her information. Additional studies, GAO Reports and Congressional Hearings confirmed her findings and her complaints about California's regulators failing to identify serious problems in nursing homes. Ila again supplied evidence and witnesses for these hearings. Studies in other states across the USA have followed. They have revealed similar problems in corporate run homes nation wide.
Ila is renowned for her bluntness. She uses her personal experiences to make her points and bring home the human costs of the corporate marketplace. She calls a spade a spade and is intolerant of glib phrases and evasive jargon. She has paraded the streets with placards, mounted protests and at public inquiries she has aggressively challenged politicians with the money which each received from corporate chains. National television has supported her. She has been the moving force behind many documentaries describing the failure in the corporatised US aged care system.
The corporate system accuses her of being unbalanced and unreliable. Those who know her consider her to be a modern saint. She has been called the Mother Teresa of aged care. More conciliatory groups referring to Ila "deplore that kind of advocacy". Subsequent investigations by others have consistently confirmed the substance of Ila's assertions and she gets results. People who have been fired or voluntarily left the corporatised aged care system have quietly told Ila that they didn't know what to do with her. They could not scare her away and she could not be bought off. Some politicians who faced the flood of material sent by Ila thought she was "full of baloney" but when they went to nursing homes and looked themselves they realised that she was telling the truth.
Ila does what she thinks is right regardless of the consequences - living on the edge when need be. One story is that she went with the daughter of an elderly lady who had gangrene to the nursing home at 1am. Together they quietly untied the lady's restraints, kidnapped her and took her off to hospital so that she could receive proper treatment for her gangrene.
Ila won a $775,000 settlement against Creekside, the nursing home where her mother developed massive pressure sores. Spurred by Ila's example community groups in many states are now working together to do what regulators have failed to do - take the corporate chains to court and extract the sort of penalties which will make them respond or go out of business. The people are holding them accountable. Juries have been appalled at conditions and angry when nursing administrators have come forward to explain how they were forbidden to employ more staff. They have awarded massive punitive damages.
Ila and her group in California have commenced Qui Tam court actions against a number of corporate chains on behalf of the US government accusing them of failing to provide the care which they promised in their brochures and failing to meet their contractual obligations to Medicare. A Qui Tam court action this past February succeeded against Crestwood Convalescent Homes, forcing the chain to return more than $800,000 in Medicare money to the federal government. Her group's action against Sun Healthcare has been held up by the bankruptcy proceedings. Her Qui Tam against Covenant Care is proceeding. Her efforts have attracted the attention of one of the large legal firms that successfully prosecuted the tobacco companies. They are acting in her behalf using California Consumer Fraud Laws against the giant group Manorcare/HRC. She accuses them of not supplying the care they promised their residents - care for which they were paid by both private pay and government funds. She hopes to return all private pay monies back to the families whose loved ones suffered deficient care.
As a result of Ila's efforts there have been many television programs and press reports investigating and reporting on what has happened in aged care. She has appeared in some of these herself. She has taken an interest in the corporatisation of for profit aged care in other countries. She has appeared on Japanese Television and has written letters to the Canadian press warning that country not to adopt the US model of care.
Within the dedicated and relentless crusader there lurks a bubbling extrovert with a marvelous sense of humour. Those who meet her warm to her ability to see the funny side of things. Her frequent emails to her circle of supporters contain jokes, cartoons and sometimes simple human stories and even poetry. The abuse of the elderly by corporate chains is never funny. Anyone attempting to make it so when talking to Ila is unlikely to forget the experience.
Ila is now widely admired and the many families she has helped sing her praises. She hates personal publicity and wants nothing for herself. She recognises that personal publicity aids her cause and tolerates it. She is the subject of a television documentary which is in preparation. One of the journalists who has covered her battle is writing a book about her.
Ila's story and character emerges from the press reports describing her activities. These are the people who interviewed her, her friends and her critics.
Ila also has her own web site http://www.ilaswan.org. Click on it to go there.
The many extracts on this page are from copyright material. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that all of the matters referred to are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of the allegations made about corporate care
FATAL NEGLECT :::: IN POSSIBLY THOUSANDS
OF CASES, NURSING-HOME RESIDENTS ARE DYING FROM A LACK OF FOOD AND
WATER AND THE MOST BASIC LEVEL OF HYGIENE
Time Magazine OCTOBER 27, 1997
The idea of using death certificates to try to prove fraud was born at the Creekside facility. Shortly after Rhoda Johnson moved into Room 52 of the nursing home in 1992, her daughter Ila Swan became concerned about her care. Swan, a 57-year-old former telephone worker, says her anxiety grew when she saw a woman in Room 51, across the hall, try to climb out of bed after her calls for a nurse went unanswered for an hour.
According to the woman's roommate, as the woman struggled to get out of the bed, she toppled and struck her head on the tile floor. She lay there for 20 minutes, her cries for help going unanswered by the staff as a pool of blood grew around her. She died a short time later.
Swan visited the county records office to review the woman's death certificate and those of others who had died while residing at Creekside and other nearby nursing homes. She was startled to find 10 questionable causes of death listed on the first 30 she reviewed. "They'd listed malnutrition, dehydration, bedsores and urinary-tract infections as causes of death," Swan says. "These nursing homes were killing people."
Soon Rasor and investigator Robert Bauman heard of Swan's work. Intrigued, they began working with Packard to obtain records listing the cause and place of death for every Californian who died from 1986 to 1993. More than 300,000 had died in nursing homes
Rhoda Johnson, Ila Swan's mother, lived at Creekside nearly two years, until July 1993. Her family alleged in a lawsuit that the nursing home essentially abandoned Johnson: she was often left lying in her own waste, hungry, cold, unfed and unturned.
One day she complained to Swan that her hip hurt. With her sons' help, Swan lifted her mother out of the bed, pulled up her nightgown and collapsed in sobs. "She had this bedsore on her hip that was so deep," her daughter recalls, "that I could see the hip socket and leg bone moving inside the hole." Her bottom was bruised and caked with dried feces, which Swan peeled off with her fingers amid her tears.
"I never had looked under the covers," she says. "I didn't think I had to." Johnson, now 98 and living in a Utah nursing home, doesn't talk much about her experience. "Creekside was mean to me," she says. "They didn't give me a drink, they yelled at me, they hurt me." She received a $775,000 settlement in May 1996.
Clinton Calls for Reform Of Nursing Home
Industry; Surprise visits, higher penalties ordered
The San Francisco Chronicle JULY 22, 1998
Yesterday, California's nursing home industry also came under fire in San Francisco, where a coalition of nursing home activists and relatives of nursing home patients announced a major lawsuit against two nursing home chains.
The suit, the first whistle-blower action of its kind, alleges that Sun Healthcare Group and Crestwood Hospitals Inc. collected millions of dollars in Medicare and Medi-Cal payments while providing substandard care. The two chains operate 24 facilities in Northern California.
According to their analysis of state death certificates from 1986 through 1993, the coalition said nearly 22,000 California nursing home patients died from malnutrition, dehydration, infections or internal obstructions that theoretically could have been prevented.
Brenda Klutz, the head of nursing home licensing in the state Department of Health Services, reacted angrily to the allegations. The critics are "making serious allegations that can't be substantiated," she said. "They did not have access to medical records, and I don't like people who prey on the fears of people in nursing homes or their families."
"At every turn the oversight system has failed," said Ila Swan, a Vacaville nursing home activist who is among the parties who filed the suit. "I felt I'd gone through all the systems that should have been there to protect the patients and they had all failed me."
State gets it from two sides on nursing
The Sacramento Bee Dec. 10, 1998
Patient advocates and industry representatives accused the state of inconsistent and lax oversight of California nursing homes during a daylong workshop on elder abuse this week.
Ila Swan, who became a national advocate for nursing home patients after her mother successfully sued a facility for neglect, said disputes over individual citations are beside the point.
"The industry is talking about someone who fell out of bed and maybe broke a hip," she said. "We're talking about daily neglect and a shortage of staff to maximize the profit to nursing homes. And in the meantime, our parents are left lying in their own waste because there's nobody to change them."
No-frills crusader attacks nursing home
The Sacramento Bee Jan. 5, 1999
Mareva Brown Bee Staff Writer
VACAVILLE -- Ila Swan's passion was born in a tiny room at a Vacaville nursing home, where she went almost daily for nearly two years to feed her fragile mother.
One January day in 1993, a sobbing patient told Swan that her 88-year-old roommate, who was supposed to be under 24-hour watch after suffering a stroke, had fallen from her bed in the middle of the night, cracking open her skull. The woman lay bleeding for 20 minutes before nursing staff discovered her, the roommate told Swan, and died the next day.
Outraged, Swan looked up the woman's death certificate to see if the coroner had found the nursing home negligent. As she thumbed through hundreds of records in Solano County, she recognized the names of other former patients at the facility. She was horrified to see how they had died.
"Dehydration, malnutrition, sepsis from bedsores," said Swan. "That's murder."
The woman's death and Swan's subsequent concerns about the care her mother received at the facility spawned a mission that has consumed all of her spare time and most of her disability pension. At 58, Swan has become one of the nation's most formidable crusaders against nursing home abuses. Her work, which includes files on more than 26,000 deaths in nursing homes, has provided the foundation for two federal probes and a state reform effort.
"We are grateful," said Jill Gerber, spokeswoman for the U.S. Senate's Special Committee on Aging, which ordered the U.S. General Accounting Office to investigate nursing home care after seeing Swan's files.
But the report echoed Swan's condemnation of the nursing home industry and the ineffectiveness of the state agency charged with monitoring care.
"Nursing homes have hurt a lot of people," she said with characteristic bluntness. "Their families remember. And there are a lot of people out there who would like to see something done."
Many credit Swan -- a plainspoken, no-frills, former telephone company worker, who used a wheelchair for years after falling from a telephone truck -- with breaking through a vast and seemingly uncaring bureaucracy to force change.
"Ila is one of my heroes," said Dina Razor, a noted independent investigator in the Bay Area whose work on military fraud helped launch probes into Pentagon spending. More recently, she began looking into nursing home fraud and said Swan's files gave her the ammunition she needed to force federal action.
"She doesn't care what people say about her," Razor said. "She's not interested in a position of power; she's not impressed by rubbing elbows with the influential. And she doesn't care who gets the credit -- as long as things change."
Swan also has her detractors.
"I've never met the lady, but among all the self-appointed activists, she's probably the most extreme and least credible of all of them," said Gary Macomber, executive vice president of the California Association of Health Facilities, which represents nursing homes.
The billboard was enough to keep Swan from being included on a statewide task force of some 50 advocates, industry representatives and state regulators who were convened in October to review the GAO's criticisms.
"We didn't want an adversarial tone to our meeting; we wanted a dialogue," said Tom Porter, state representative for the American Association of Retired Persons.
Swan went to the meeting anyway, conducted herself "professionally," according to Porter, and was invited to participate in the final two meetings.
The experience fueled Swan's anger over the January 1993 death of the woman who fell from her bed. She expanded her search of death certificates, eventually combing the files of all 58 California counties and spending thousands of dollars of her own money.
She peppered the desks of politicians in Sacramento and Washington with strongly written letters that detailed alleged abuses and urged an overhaul of the Department of Health Services. And she called the relatives of patients whose death certificates she'd collected, urging them to sue.
Weekly, she visits nursing homes. If she doesn't have a client to see, she heads for the nearest alert patient, introduces herself and asks about his or her family.
"While I'm talking, I'm looking and smelling," she said. "I act like I'm straightening their skirt and I'm checking for bruising. I test the back of their hands for dehydration."
Some frown on that hands-on advocacy. But Swan doesn't care.
"Ila's got nothing to lose," said Lesley Ann Clement, her attorney. "Because she's seen the horrors. She's lived it. And she doesn't want it to happen anymore."
Legislators look at nursing home
DAILY REPUBLIC Jan 20, 1999
By Catherine Moy
SACRAMENTO - Six months after a federal report showed that one-third of Californias nursing homes cause death or serious harm to their patients, state legislators began searching for ways to stop the problems. State senators and Assembly members met on Tuesday during a joint hearing titled the ``Quality of Care in California Nursing homes.
The four-hour hearing - which followed three months of study and discussion by stakeholders in nursing home reform - produced a multitude of ideas, though it was never clear what the ultimate outcome would be. Several lawmakers seemed eager to craft bills to strengthen enforcement with tougher fines, while increasing pay for certified nursing assistants, who do the bulk of the patient care at large skilled nursing facilities.
Most witnesses disagreed politely - until the end of the session when the public was allowed to speak. In less than 20 minutes, the public speakers raised more issues and reasons that had not been touched on in the previous four hours.
Vacaville resident Ila Swan, who became a national advocate after her mother developed bone-deep bedsores in a Vacaville nursing home, stood up and told the legislators her theory on the problems. It comes down to two words: Political contributions.
Swan knows a bit about the nursing home industry. She received national attention after finding hundreds of death certificates showing patients dying in nursing homes of starvation, dehydration and bedsores.
The General Accounting Office took notice, investigated and found the poor conditions in California nursing homes. In July, the Senate held subcommittee hearings in Washington based on Swans work. Swan on Tuesday told the legislators that most of them had taken money from the nursing home industry and that, in effect, is why the system allows neglect and abuse of the elderly. It is why there hasnt been meaningful reform in years, Swan said.
``It doesnt matter how much they want to do their jobs, they cant. Enforcement is lax and nursing homes dont always have to pay their fines for their poor care, said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. When they do, the fines are relatively small compared to their profits.
Fighting Elder Abuse
CBS NEWS WEB PAGES Feb 2000
"I went through it with my mother, and nobody was there to help me," Swan explains. Outraged by the harm a nursing home did to her mother, she is now a wig-wearing crusader who goes undercover and looks for signs of abuse and neglect for others - for free.
Families contact her because, it seems, no one else is listening.
Swan reports her findings to the families and files reports with state regulators who routinely dismiss them.
"You try the system," she says. "The system's broken. It's well known the system's broken."
In a series of reports, government investigators reached the same conclusion - that the state and federal system is "inadequate to protect residents."
Well, what about the police?
"You can't get the police to come in there. Their jurisdiction, as far as I have seen, stops at the front door of the nursing home," Swan says.
Swan says of all the homes she had been in (close to 600), she would only put one of her loved ones in about six of them.
Attorney general, activist tackle elder
Daily Republic 25 June 2000
VACAVILLE - Ila Swan is prepping her trailer of death for a road trip.
The billboard trailer used to have a big picture of former Attorney General Dan Lungren on it posted next to a victim of Auschwitz death camps and another similar-looking victim, an elderly man brutalized inside a California nursing home.
She's looking to redecorate. "Oh, yes. I'm looking for a picture of (state Attorney General Bill) Lockyer - and (Gov.) Gray Davis, too," the Vacaville resident said, adding she'll take the trailer on highways and byways to alert people about nursing home abuse.
The pictures may change, but the message hasn't: Politicians such as Davis and Lockyer take money from nursing home lobbyists and fail to protect the elderly inside nursing homes, Swan said.
And come Tuesday, Swan will face Lockyer and other state officials at a Vacaville conference and ask them why. Why don't they stop the horror inside the facilities?
"I have a question for Lockyer," Swan said. "The Texas AG in one year prosecuted 100 nursing homes. What's the problem here?"
Lockyer has prosecuted one nursing home for the crimes since he took office in January 1999. He has also dedicated 20 new investigators and prosecutors to pursue elder abuse cases, in addition to launching a new operation to do surprise visits at nursing homes, said Sandra Michioku, AG spokeswoman.
Swan hopes so, but she isn't confident that they will commit to changes. "They've got to look at campaign financing," Swan said. "There are three things that will stop these deaths: stop money to politicians, put in an oversight system and make them accountable . . . and then you have to hold them criminally accountable. If they kill somebody they go to jail, just like you and me."
A congressional report released this month found that one-third of the Bay Area's 288 nursing homes between September 1997 and January 2000 hurt patients or put them at risk of death of serious injury.
AG says prosecuting elder abuse a top
Fairfield Daily Republic June 28, 2000
By Catherine Moy
"I've made it very clear that (elder abuse) is a high priority," Lockyer said. (California Attorney General)
Part of the problem is the way the system is set up, with calls of neglect and abuse going to the state licensing board, which doesn't turn them in to police and doesn't even collect fines when they find problems, said Vacaville resident Ila Swan, a national advocate for elderly in nursing homes.
Sometimes when Swan has called police, they don't respond. And when they do, they don't do a proper investigation, she said.
"All of the reports show the abuse and killing going on inside nursing homes. But everybody's focus is on community abuse, people beating up their mother at home," Swan said. "All of it should be prosecuted, but we need to look closer in the nursing homes where most abuse occurs."
Later she told the panel of prosecutors and officers: "It makes me curious that I hear law enforcement saying there's nothing in the institutions."
Swan then unleashed a litany of statistics about the unnecessary deaths of patients in nursing homes who suffer from maggot-infestations, beatings and other types of abuse.
"That's a horror I didn't want to hear," Dennison said. "That is criminal conduct that is happening inside nursing homes. (People) need to understand that this is not a licensing issue, this is a criminal issue."
Americas closest rendition to 'Mother
Comment:- The editor reprints Ila's story in her own words. Click on the link above to read it.
EDITOR'S NOTE: The article you are about to read was written by one of the nation's most controversial and provocative eldercare advocates. I decided to publish the article "as is," exactly as the author submitted it to me. Given its honest and brutal content, it will offend some and mobilize others. Nevertheless, it is a story that I believe needs to be told -- in her own words.
A Perfect Cause ::: National Reform
Movement Sparked by Nursing Home Death
Press Release May 7, 2001
Contact: Wes Bledsoe 949.854.1097
(May 4, 2001 - Irvine, CA) - The death of Eunice Allen, an Oklahoma nursing home resident, last May 13 on her 86th birthday is responsible for launching A Perfect Cause - America's Long-Term Care Reform Movement.
"Our grandmother died a horrible and painful death," says Allen's grandson Wes Bledsoe, Founder and President of A Perfect Cause. "While investigating the circumstances of her death we began to realize the scope of needless suffering and preventable deaths in America's long-term care facilities. " One person dies every 15 minutes in a long-term care facility due to deficient care, neglect or abuse.
Ila Swan, America's most passionate nursing home reform advocate, will participate in the May 10th demonstration. "A Perfect Cause is exactly what we need to clean-up the long-term care industry! We must take this reform movement to the streets and demand an end to the suffering and deaths," Swan stated.
Lawsuit charges substandard care at
California nursing homes
The Associated Press State & Local Wire May 8, 2001
A self-described advocate for nursing home reform sued an Ohio-based national nursing home chain Tuesday for allegedly providing substandard care at its nine facilities in California.
Ila Swan accused Manor Care Inc. and ManorCare Health Services Inc. of Toledo, Ohio, of failing to respond to call lights for help from patients and forcing patients to sit in their own waste. She also said the company caused patients to develop bedsores due to unsanitary conditions, lack of movement and malnutrition.
" ManorCare nursing homes have purposely short-staffed their facilities and used our loved ones as profit units," said Swan, who filed the lawsuit on behalf of herself and the general public.
"When you are dealing with human lives, you can't put profits first. These elderly are living in pain and indignity and we must do something to stop it."
Hagens Berman Announcement -- Nation's
Leading Nursing Home Chain Systemically Neglects Patients, Suit
Business Wire May 8, 2001
Activist files suit on behalf of elderly, claiming exploitation and abuse
The suit was filed on behalf of the general public by Ila Swan, a longtime activist for nursing home reform, and involves all ManorCare nursing homes in California. ManorCare operates 300 nursing homes in 31 states nationwide.
The suit alleges that ManorCare systemically failed to meet the standards of the Nursing Home Reform Act. Passed by Congress in 1987, the Nursing Home Reform Act mandates that a nursing home "must provide services and activities to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident in accordance with a written plan of care...."
"When you look at ManorCare's promotional material, you see an organization that purports to deliver the highest quality of care," said Steve Berman, the Seattle attorney representing the residents. "They use the words 'best' and 'highest quality' when they lure the elderly in," observed Berman. "The allegations of the complaint paint a far different picture -- one of abject neglect and callous disregard for the human condition.
"The complaint alleges that ManorCare proudly promotes the fact that the company's profit margins are well above the industry average," continued Berman. "What our case asserts is that ManorCare delivered these profits by instituting high patient-to-staff ratios and low quality of care."
"The elderly are our heritage -- our mothers, our fathers and our grandparents," said activist Swan. " ManorCare nursing homes have purposely short-staffed their facilities and used our loved ones as profit units. When you are dealing with human lives, you can't put profits first. These elderly are living in pain and indignity and we must do something to stop it."
The suit alleges ManorCare violated the California Business and Professions Code by engaging in unfair and fraudulent business practices, as well as untrue and misleading advertising.
California Grandmom-Activist Raises Hell
against Nursing-Home Industry
Contra Costa Times May 29, 2001
By Thomas Peele
VACAVILLE, Calif.--Ila Swan raises hell.
Ila Swan once hung a sign outside of a nursing home that said, "Free maggots with every bedsore."
Ila Swan, a nationally known activist, goes after the nursing home industry the way Ronald Reagan once went after the Soviet Union. Evil Empire? Ila Swan fights the Evil Industry.
To a reporter, Swan spoke in placid terms about nursing homes for nearly 90 minutes, her words measured carefully in stories about lawsuits and suffering and bedsores as she rocked gently in a black chair, sometimes stopping to dig an unshod toe into her office's gray carpet.
But it became too much. Too many photos spread on the floor of open, infected wounds, black eyes and emaciated bodies. Too much pain.
"I want all this killing stopped," Swan bellowed. In her words, nursing home executives quickly became "industry scumbags" and "pigs." State health officials and other advocates? Industry bedmates. Politicians? Nothing more than industry pawns.
Welcome to Ila Swan's world. A 60-year-old grandmother and retired telephone company linewoman who used to climb poles the way most people ascend a front stoop, she sues nursing homes with religious zeal.
"I know I am doing right," she said. "They think I am terrible. I put their face in it."
In February, Swan won a whistle-blower lawsuit against Crestwood Convalescent Homes, forcing the chain to return more than $800,000 in Medicare money to the federal government. It drew the attention of Steve Berman, a high-profile Seattle attorney who won legal victories against the tobacco industry in 13 states.
He agreed to represent Swan against her newest adversary, ManorCare Health Services, which owns two nursing homes in Walnut Creek and more than 300 across the country. In a lawsuit filed this month in Los Angeles County Superior Court, Swan alleged horrid conditions in the Walnut Creek homes and in seven others the Ohio-based company owns in California.
It made her friends with a U.S. senator from Iowa, lawyers and private investigators. It brought coverage in Time magazine, contacts with nursing home advocates across the country and a Web site, IlaSwan.com.
But it never softened her unweathered edge.
When she testified before the U.S. Senate Committee on Aging, its chairman, Sen. Charles Grassley, R-Iowa, warmed to her and promised a fight.
"I think she wanted to kill me,'' Rasor recalled recently. "Not everyone has Ila's sense of justice. She gets very frustrated with people who don't have her internal strength."
Swan, a Utah native, insists she never intended to become one of the nation's most unrestrained nursing home activists. But when she found her mother's bedsores growing worse, lying in her own waste day after day, Swan got active. A tropical depression grew into a raging hurricane overnight.
She encountered an unresponsive system. State health officials ignored her at first. So did politicians. Eventually, she moved her mother to a better home. Her mother sued and won a $775,000 settlement against the nursing home that mistreated her.
But Swan never stopped. "My phone kept ringing," she said. People read about her mother's suit and her feisty daughter. Swan started walking into nursing homes unannounced, wearing a wig and sunglasses to disguise her appearance and recording her observations on a hidden tape recorder.
Swan started flying around the country, and didn't like much of what she saw.
In Washington, she walked out of a National Citizen Coalition for Nursing Home Reform conference because nursing home administrators and lawyers also attended it, and because she learned the reform organization accepted funding grants from nursing home companies.
"They take money from those scumbags," Swan said. "I mean, come on. They're corrupt."
Elma Holder, the reform organization's founder, said of Swan, "Think she has done some good research that has been very useful." But, Holder added, Swan often expresses "hatred toward other advocates and individuals. Our styles are very different. I deplore that kind of advocacy. I am totally against her attacks on people."
But in Swan's world, no gray areas exist. Many people admire her.
"I think she's brought more attention to the nursing home realm in the last five years than anyone did in the last 40 years," said Violet King, who runs a nursing home patient advocacy group in Illinois.
"We now have statistics of abuse and neglect because of Ila. Before, everything was an 'isolated incident.' We've been empowered by Ila's guts, her risk to go forward with innovative things."
ILA SWAN'S LAWSUIT against ManorCare Health Service Inc. includes allegations of poor care at the company's nine California nursing homes, including the two it owns in Walnut Creek.
ManorCare Hit with Lawsuit Alleging
Systemic Elder Neglect
Nursing Home Litigation Reporter June 4, 2001
CASE: Abuse and Neglect Litigation: Swan v. Manor Care of Am.
A private attorney general action has been filed in a California state court against ManorCare Health Services Inc. and its parent corporations for allegedly misleading the public about its "high-end" nursing homes. The complaint claims ManorCare has achieved profit margins exceeding the industry average by maintaining inadequate staffing levels, resulting in widespread care problems at its facilities.