A little over one year after suing a Carlsbad company for understaffing nursing homes it owns through subsidiaries across the state, California Attorney General Rob Bonta announced a $15 million settlement Tuesday that includes three years of monitoring to ensure that a range of operating criteria are met.
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The deal, filed with the court on July 20, affects 22 of the original 27 defendants named when the suit first appeared in Superior Court. Aaron Chesley, named as co-founder of Sweetwater Care in Carlsbad, and James Gamett, said to be managing partner of Sweetwater Private Equity, an organization not named in the lawsuit, were dismissed from the legal action, as were three limited liability companies: Sweetwater Care OPCO, AJC Healthcare and JBG Partners.
The dismissals leave 22 remaining limited liability companies, all alleged to be connected to Sweetwater Care or its subsidiaries, that are subject to the settlement’s stipulations.
More than a dozen skilled nursing facilities, most located in rural California cities, are named and must comply with a long list of requirements that appear designed to repair what the Attorney General’s office alleged was chronic understaffing. According to the original suit, investigators documented more than 14,000 instances of illegal understaffing from 2020 through 2024, which allegedly exposed residents “to preventable neglect, abuse and injuries, including fractured bones that went days without assessment or medical care, patients with head trauma leaving the facility unbeknownst to staff, unwitnessed falls and pressure injuries so severe that a patient’s hip bone was visible.”
An injunction that is part of the settlement requires all Sweetwater facilities to provide at least 3.5 hours of direct care per patient per day, with 2.4 hours per day by certified nurse assistants, and to staff a registered nurse for at least eight hours per day, with no staff operating outside their licensed capacity.
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The settlement names Christopher Cherney of Skilled Review Consulting to serve as a “compliance monitor” with real-time access to each facility’s electronic records system. Sweetwater Care is required to spend $2.5 million on the compliance program, which would last for at least three years. Quarterly announced, or unannounced, site visits and/or “desk audits” of operations are also required.
Each of Sweetwater’s skilled nursing centers must document the provision of six types of care, including resident bed repositioning to prevent skin breakdowns, full body checks, bathing, fluid intake to prevent dehydration, dental evaluations and all reports of suspected resident abuse. Centers must also file quarterly reports on several healthcare quality measures that include: falls with major injuries, pressure ulcers, urinary tract infections, catheter use, decline in ability to perform activities of daily living, antipsychotic medication use, decline in mobility, and hospitalizations and emergency department visits per 1,000 days of care provided.
In addition to the cost of the compliance program, Sweetwater is required to pay the state $12.5 million in penalties “for violations of minimum staffing laws and acuity needs.”
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