Elderly often face neglect in California care homes

LOS ANGELES (AP) — In her final months, Elaine Geslicki, a bedridden dementia resident at a home for seniors in the Los Angeles area, had difficulty communicating. But by the time the owner of Court Yard Estates sent her to the hospital in an ambulance, the severe pressure sores and bite marks from rats gnawing on her flesh spoke for themselves.

"It was negligent and preventable," said Jasper Muñoz, a former caregiver who worked at the home for eight months through May 2017. When he complained that the number of rats in the home was out of control - about a year before Geslicki died - he said the care home's operator, Dimitri Zafiris, just laughed and said: "Why don't you just feed the rats?"

Zafiris later would face elder abuse charges related to Geslicki's case and would be accused of wage theft by some of his care-home employees, who say they are owed more than $221,000. Zafiris is not the only care-home owner cited for mistreating seniors as well as workers.

An investigation by Reveal from The Center for Investigative Reporting found that some operators of senior board-and-care homes that violate labor laws and steal workers' wages - previously exposed by Reveal - often also endanger or neglect their residents, sometimes with dire consequences.

Reveal analyzed thousands of licensing records and hundreds of U.S. Department of Labor cases in California and conducted two dozen interviews with workers, residents and their family members.

Reveal's review provides the first comprehensive accounting of failures in care homes whose operators preyed on vulnerable caregivers, many of them poor immigrants, and elderly residents. In California, which has the most licensed senior care homes of any state, federal data shows that operators broke minimum wage, overtime or record-keeping laws in more than 500 cases over the last decade. In 1 in 5 of these cases, operators were cited for health and safety violations that endangered residents, Reveal found.

Asked about Reveal's findings, Vicky Waters, a spokeswoman for California Gov. Gavin Newsom, said two state agencies are working on a new enforcement initiative to crack down on the mistreatment of workers and seniors.

"The Administration is committed to protecting the rights of workers and well-being of consumers," Waters wrote in an email. "The California Department of Social Services and the California Department of Industrial Relations are launching an effort under which the Departments will work closely together to ensure compliance with labor and licensing laws, including data sharing, joint meetings with licensees, and legal actions up to and including license revocation."

Waters declined to elaborate on the developing plan, including when it would start and which senior care homes would be subject to closer scrutiny.

In May, Reveal reported widespread exploitation of caregivers in senior residential care homes, many of whom earn as little as $2 an hour to work around the clock with no days off, while some industry operators make millions. Caregivers routinely are harassed and fired if they complain.

Reveal also found that companies caught stealing from workers continue to operate illegally despite outstanding wage theft judgments, leaving scores of workers unpaid. California regulators had said they could not strip these companies of their licenses unless residents' health and safety were threatened.

Similar lapses that endangered Geslicki and other residents at Court Yard Estates have played out in care homes across the state, where homes cited for violating federal labor laws also often endanger and neglect residents in ways big and small.

For example, at Walnut Creek Willows care home in the San Francisco Bay Area, investigators found residents sitting in soiled underwear and a resident wandering about with a bruised and bloody foot. The staff ignored both, records show. At Sonia's Care Home in Stockton, a resident who fractured a hip in 2017 had to be hospitalized, but staff were cited for failing to notify licensing officials as required. That same year, Spring Hills Assisted Living in Redding lacked records stretching back four years that staff had received the care training required by the state. Walnut Creek's president did not return a call requesting comment. The owners of Sonia's Care Home and Spring Hills declined to comment.

In 2017, a year after Nora's Home Care #2 in Fair Oaks, northeast of Sacramento, was caught violating federal labor laws, a man died not long after being admitted to the care home. Medical records show the man's diet was supposed to be restricted to pureed food, but Eleonora Berci, the home's administrator at the time, told state inspectors that she had been distracted and fed him solid food. She also forgot to tell the other caregiver about his restricted diet. He was fed stew, macaroni and applesauce.

After noticing that he was spitting out saliva, Berci sent him to the hospital, where he told doctors that something was stuck in his throat. He was treated for bronchitis and sent back to the care home, where caregivers gave him applesauce with his medications. He began throwing up and aspirating and was sent back to the hospital an hour after he was released. He died two weeks later of aspiration pneumonia and food in his esophagus. Berci declined to comment for this story.

State and federal investigators cited the operators of these care homes for health and safety violations involving seniors, as well as labor violations such as wage theft.

More than a year before Geslicki died, Muñoz, the former caregiver, said he encountered a rat preying on another resident who was near death. As she lay in bed, the rat bit her lip.

"I threw my slipper at her body to get them away," Muñoz said. "The rats sensed she was going to pass away."

A review of state licensing records supports the worker's account of the rat infestation at the care home in Rancho Palos Verdes, an upscale community along the coast south of Los Angeles. It was one of three care homes operated by Zafiris. The other two, Ocean Park Residence I and II, were in Santa Monica.

Soon after Geslicki, 91, returned to the care home from the hospital in February 2018, state inspectors interviewed a staff member who told them that he saw a rat and rat droppings around Geslicki's blanket. Geslicki was missing skin on her left hand, and the arch of her left foot had bite marks.

She died four days later. The cause was sepsis and pneumonia, according to her death certificate. Two small rodents were caught at the care home just days after Geslicki died.

The care home's treatment "resulted in R1 (Geslicki) suffering a serious bodily injury, including the development of numerous pressure injuries between August 2017 and February 2018 and sustaining rat bites to R1's body, ultimately leading to hospitalization," state inspectors noted in a February 2019 report. At least 10 pressure sores covered her back, thigh, feet and elsewhere.

State records do not explain why it took almost a year for inspectors to move residents out of the care home and temporarily suspend Zafiris' license to operate the three care homes. Court Yard Estates was fined $10,000 for neglect and failing to report Geslicki's injuries, hospitalization and death to licensing officials. It is not clear how long Geslicki had been dead before state regulators learned she had died.

Adam Weintraub, a spokesman for the California Department of Social Services, declined to comment on the state's investigation, citing its pending case against Zafiris. The state is seeking to permanently revoke his care-home licenses and ban him from ever operating a care home in California, according to state documents.

"It's so unfair that my business has been shut down," Zafiris said in a telephone interview. "They ruined me for life. You are guilty before you're proven innocent. I have some responsibility for what took place, but caregivers were responsible for the rats. There's no connection between the rats and Elaine's death."

In January, the California Justice Department charged Zafiris and Nelia Garcia, one of his employees, with elder abuse involving Geslicki's care. In court filings, state prosecutors say they allowed her "to suffer, or inflicted thereon unjustifiable physical pain or mental suffering." Zafiris pleaded no contest and awaits sentencing in January. Garcia is said to have fled the country and could not be reached for comment.

In recent years, the state also cited the care home for hiring workers without conducting criminal background checks and for violations such as peeling paint, broken lights, dead flies encrusted on dusty windows, a broken air conditioning and heating system and a lack of carbon monoxide detectors. Workers told Reveal that the care home often ran out of basics, forcing them to dip into their own money to buy milk, soap and other supplies.

Former workers say the operator also underpaid staff. Last year, Muñoz and another former caregiver filed wage theft claims totaling more than $221,000 against Court Yard Estates. They said they were paid as little as $3.33 an hour. Their claims are pending. The state labor commissioner's office in December 2018 imposed a penalty of nearly $197,000 against Zafiris' company for failing to get workers' compensation insurance. Zafiris appealed. His company, Ocean View Residence, which operated the three care homes, filed for bankruptcy in April.

"He was very greedy," Muñoz said. "He has accumulated a lot of money over years and years off the backs of workers."

Zafiris' Facebook postings and photos are a testament to his family's jet-setting around the world. Last year, they traveled to Paris, where they posed in front of the Eiffel Tower and Notre Dame and dined at the famed La Mère Catherine next to the Sacré-Coeur Basilica. In 2017, the couple visited the French Riviera. Before that, the family took in sunsets at a resort in Puerto Vallarta, Mexico.

"Margherita (sic) time Mexican style," Zafiris posted on Facebook with a photo of the family celebrating with a toast.

In an interview, Muñoz said Zafiris called him after learning he had filed a wage theft claim. Zafiris, he said, lashed out: "You don't know who you're dealing with, I can make a phone call, I'm connected to the Mafia."

"No, I never did that," Zafiris said in an interview. "There is no such thing. These caregivers are gold diggers."

Muñoz said he slept on a mattress on the living room floor or the couch. At night, rats skittered along the floor and chewed through care packages residents had received from their families. When the light flicked on, they'd scatter.

Geslicki's son, Mark, who lives in Rancho Palos Verdes near the care home, said he learned about the rats after receiving an anonymous text in early 2018, several months before his mother died. The message said his mother had been bitten by rats and was in danger. Caregivers then told him that they had seen rats in the living room. Mark Geslicki said he confronted Zafiris, who took him on a walk around the care home. Mark Geslicki said he spotted dead rats in a bucket by the side of the house. But he said Zafiris assured him that he had hired an exterminator who was handling the infestation.

"There was a rat problem, but I thought he'd addressed it," Mark Geslicki said. "I believed he was doing everything he could."