The Santa Fe New Mexican reported the history of neglect at Casa Real.  Inspections and investigations paint a troubling picture of life at the nursing home: medication errors, expired food and drugs on shelves, unreported injuries and assault, poor care of wounds, inadequate safeguards against spread of antibiotic-resistant infection, nurse understaffing and more.

Problems also have occurred at the Santa Fe Care Center, a sister facility of Casa Real, according to inspection reports.  A resident at the Santa Fe Care Center was threatened with eviction last year because his family complained about his care, an inspection found. The inspector also reported seeing staff ignore a woman’s repeated pleas for help as she sat in a wheelchair near a nursing station.

The troubles at Casa Real and the Santa Fe Care Center aren’t new. State inspectors in at least the past 15 years have cited serious deficiencies in resident care. The office of the state long-term care ombudsman, which serves as an advocate for nursing home residents, reported 428 complaints against Casa Real and 105 complaints against the Santa Fe Care Center in the past two years. The top complaints dealt with discharge, administration of medications, staff attitudes and failure to deliver ordered care.

State and federal regulators have allowed the homes to continue to operate and accept Medicare and Medicaid payments, although the facilities have faced substantial fines.  Ownership of the homes, now operated by Preferred Care Partners Management Group of Plano, Texas, has changed several times.

The for-profit facilities are the only skilled-nursing homes in Santa Fe that take Medicare and Medicaid payments, meaning area residents must accept conditions at the homes if they cannot afford private-pay nursing and want to stay in Santa Fe.

Conditions at both nursing homes are the subject of a lawsuit filed against their operators by the state Attorney General’s Office, which alleges the homes received hundreds of millions of dollars from Medicare, Medicaid and private payers without delivering even basic care.

The lawsuit alleges that Preferred Care defrauded Medicaid by having insufficient staff to meet the needs of residents at its Santa Fe nursing homes, as well as at facilities in Gallup, Las Cruces, Bloomfield, Española and Lordsburg. Also named as a defendant is Cathedral Rock, former owner of the homes.

The department conducted its last standard health inspection of the nursing home in April and reported 37 deficiencies, more than three times the average number of health deficiencies found in all New Mexico nursing homes. Among the reported problems:

• Medications were not administered at proper doses or on time. One resident was supposed to be given a medication daily but didn’t receive it on 13 days in March. Also, residents didn’t receive medications because the home didn’t have them available. Expired medications were found in drug storage.

• A female resident who was supposed to receive a shower three times a week hadn’t had a shower for a week. “I got a shower cause I was begging for it,” the resident told an inspector.

• Bathroom pull cords for call lights were unreachable if a resident fell.

• Residents were not receiving the number of physical therapy sessions ordered by physicians. “This deficient practice … is likely to increase falls resulting in bruises, lacerations, broken bones, head trauma and death,” the inspector’s report said.

• Food was not served at the proper temperature, and food in refrigerators was older than its expiration date.

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