WFAA had a troubling investigative report on the care provided at nursing homes in Texas.  Part One is here.  Part Two investigates the nursing home industry hiring criminals to care for our loved ones.  A six-month WFAA investigation found 200 aides certified to work in North Texas nursing homes have serious or violent criminal histories.

The most troubling part is that current regulations in Texas allow many certified nurse aides (CNAs) with criminal histories to work in nursing homes legally.  The WFAA investigation found CNAs who have been “convicted of crimes that should make them ineligible to work, yet slipped through the regulatory cracks — and continue to remain state certified and employable.”

The WFAA review found CNAs with arrests for crimes that include the following: aggravated assault with a deadly weapon; continuous violence against family; injury to a child; abandoning a child; aggravated robbery; aggravated sexual contact with a child; and burglary.

There are three major oversight flaws, according to the WFAA findings.

Loophole 1: Inadequate initial background checks

The first involves the initial certification.

The state requires DPS to conduct a criminal background check prior to an applicant being certified. That’s different from Texas requirements in other industries, for example, like child daycare in which a national background check using fingerprints is required.

The WFAA review found the DPS checks apparently fail to uncover various state convictions. That’s resulted in nurse aide applicants getting certified, though they should be barred for life.

Loophole 2: No background check on re-certification

A second flaw appears in the re-certification process. The state requires a nurse aide to get re-certified every two years, yet does not require regulators to re-check a CNA’s criminal background.  Instead, any further background checks fall to the nursing homes.

WFAA found individuals who commit crimes that should bar them from work – and have their certification pulled – yet remain certified and employable.

Loophole 3: Deferred adjudication probation

The third and most common loophole WFAA found is buried in the state’s regulations. It says if you commit a serious or violent crime, you are eligible to become a CNA as long as you don’t have a “final conviction.”  WFAA found dozens of nurse aides who pleaded guilty to violent crimes. But since they got probation, the law allows the nursing homes to keep hiring them.

That means a nurse aide can commit a serious or violent crime, gain deferred adjudication, and successfully fulfill the terms of their probation, to avoid a “final conviction.” The individual, though often pleading guilty to a serious or violent crime to gain probation, remains eligible to be a CNA.

This can be very dangerous to any resident but especially those with dementia.  At minimum wage, a nurse aide must clean, bathe and feed as many as 30 residents at a time. That’s compounded by Texas’ lack of minimum staffing level requirements.

They have dementia, Alzheimer’s, symptoms that cause them to have a lack of communication,” said Ernest Tosh, an attorney who handles nursing home abuse cases across the United States.

They can’t express exactly what happened, which is why violent offenders should be screened out from working in these facilities,” Tosh said. “They can physically or sexually assault an individual and there be no repercussions because that individual can’t identify them or communicate what happened.”

I think our state needs to recognize that nursing homes are not as poor as they claim to be,” said J.T. Borah, an attorney who specializes in nursing home abuse and neglect. “If the industry were to finance and staff at the level they were supposed to, they could afford better employees. They could have better applicants.”

 

The Age published an article on recent deaths caused by untreated flu.  The fatal flu outbreak at St John’s Village nursing home caused the death of 10 residents and two others from respiratory illness.  The government investigation blames serious management failures–it took days after infections began in August for management to report the outbreak.  By the time they did, 16 residents and eight staff were already sick.

In response, the St John’s Village nursing home accepted the resignation of its own former acting care services manager and referred him to his professional body for potential sanction.

The Clarion Ledger reported the settlement between the Department of Justice and a Georgia nursing home and its management company for “grossly substandard care”.  Hyperion Foundation, the owner, and AltaCare Corp., the management company, agreed to pay $1.25 million to resolve allegations of Medicare and Medicaid fraud for failing to provide care at Oxford Health and Rehabilitation nursing home.

The poor quality and lack of staff caused serious health issues including pressure ulcers, dehydration, malnutrition, and falls according to the government investigation.  I hope the DOJ continues to investigate the adequacy of the services provided to nursing home residents to increase quality and to rid the industry of the waste, fraud, and abuse that is so common.

 

 

 

WFLA had an article about the horrific neglect and abuse suffered by Willie Johnson at the hands of the caregivers at Habana Health Care Center owned and operated by Consulate Health Care. His daughter Tonya Baker said her elderly father is living in poor conditions and shared photos to prove it.  “Not taking care of my dad, not feeding my dad, going in there finding my dad, wet Pampers, Depends, not being changed,” she said.

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“My daddy’s not getting the care that he’s paying for to stay in that facility,” Baker told me.  Baker has filed five complaints with the State’s Agency for Health Care Administration about the nursing home. Four out of five times, they found the nursing home violated its own rules or law. But despite the state’s involvement, Baker says problems persist.

“I also went in there and had them take my daddy’s air conditioning out the wall because he had a lot of mold in there, in the air conditioner and in the air conditioner wall,” explained Baker.

The photos include one where he has a busted lip. Baker said the facility told her he was punched by a roommate. Another photo shows her father with a gash on his forehead after a fall in the shower.

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The Japan Times reported a good example of what happens when a nursing home is understaffed and the caregivers get burnt-out from being overworked.  Hisashi Minakawa, a caregiver at a Tokyo nursing home was arrested over the murder of an 83-year-old resident at the facility in August, the police said.  Minakawa admitted to the killing, the police said. The victim, Kan Fujisawa, “repeatedly wet the bed and I couldn’t stand it anymore,” Minakawa was quoted by the police as saying.   Fujisawa suffered Parkinson’s disease and could not control his bladder.

The killing took place in the early hours of Aug. 22. According to the police, Minakawa lost his temper after Fujisawa wet the bed multiple times the previous night. He strangled Fujisawa, threw him into a bathtub and drew hot water, according to the police.  Minakawa had been working a night shift with another worker on the night of the homicide but was alone with Fujisawa in the bathing facility.

Prior to his arrest he told the police he found the victim dead after he was away tending to an emergency call within the nursing home. But there was no record of such a call, according to the police.  The police launched the murder investigation after spotting evidence of strangling — a broken bone in Fujisawa’s throat.

Wood TV reported that Yahira Zamora, an employee at Crystal Springs assisted living facility, will spend six months behind bars in connection to the freezing death of an 85-year-old woman.  Zamora appeared in court for sentencing in the October 2016 death of Kathryn Brackett.  Brackett had Alzehimer’s disease. She walked out of the assisted living facility and froze to death outside.

A second worker – Denise Filcek – was also charged in Brackett’s death. She pleaded guilty to one count of intentionally placing false information on a health chart.  Zamora pleaded no contest to second-degree vulnerable adult abuse for allowing Brackett to get outside unnoticed. She admitted she heard an alarm go off, but never checked the door.

 

The 11Alive Investigators have uncovered new information about the Atlanta nursing home, owned and operated by the chain SavaSeniorCare, accused of not responding fast enough to save a dying veteran.  11Alive introduced you to James Dempsey caught on hidden camera begging Sava’s nursing home staff for help before dying in 2014.

The 11Alive Investigators discovered a former employee claims she and others complained about staffing shortages for years before and after Dempsey’s death at the facility. The claims were made in a 2015 deposition from Mable Turman, a CNA, or certified nursing assistant, who is seen in the hidden camera video inside Dempsey’s nursing home room while is gasps for air.

Turman made those claims during a deposition with Mike Prieto, an Atlanta attorney representing the Dempsey family.

Prieto: “Did you personally make a request for an additional CNA on the Alzheimer’s ward on the night shift?”
Turman: “Me and the other CNA constantly have.”
Prieto: “Do you feel like the facility is understaffed?”
Turnman: “Now? Yes.”

The hidden camera video shows Dempsey pressing his call light for help numerous times. At one point, it took nursing staff eight minutes to respond.  In the video deposition, Turman did not seem surprised with the delayed response.

“I’m gonna be honest, I don’t think they have enough staff in order for me to get to that call light on a prompt basis because we have been asking for an extra CNA at night,” said Turman in the deposition.

After the deposition, documents show the nursing home continued to experience staffing issues.  According to a 2016 Medicare inspection report, an investigator identified “inconsistent staffing.”

11Alive requested an interview with Sava Senior Care, the owner of the nursing home. The operator did not provide a response.

Research proves higher staffing ratios improves care and provides better patient outcomes. According to a 2016 study published in the U.S. National Library of Medicine’s National Institute of Health, “nurse staffing levels are too low in half of U.S. nursing homes.”

The study identified research that showed “numerous studies have consistently shown that higher state minimum staffing have had significant positive effects on staffing levels and quality outcomes.

Federal law requires nursing homes to have “sufficient staff to meet the needs of residents and one registered nurse (RN) Director of Nursing on duty for eight hours a day, seven days a week and licensed nursing in evening and night shifts.”

 

The Pantagraph reported the lawsuit filed against Meadows Mennonite Retirement Community related to sexual images of residents posted on Facebook by caregivers.  The lawsuit alleges that the nursing home failed to protect residents of the dementia care unit.

Residents’ privacy and dignity were violated by the alleged unauthorized and inappropriate photography of residents, including “toileting, bathing, resting in bed” while partially nude and in embarrassing and humiliating circumstances.

 Criminal charges are pending against Samantha J. Brown and Michael Shawn Scurlock. Both are charged with nonconsensual dissemination of sexual images. The criminal charges resulted from a McLean County Sheriff’s Department  investigation that prosecutors said involved reviewing about 55,000 pages of documents, including records from Facebook and internet service providers.

The nursing home was fined $25,000 in July by the state Department of Public Health for allegedly failing to protect residents and failing to report the posting of unauthorized images on social media.

WHNT reported another nursing home employee accused of sexually assaulting a nursing home resident at Mitchell-Hollingsworth nursing home.  Zack Reeves, a nursing home aide has been arrested and charged with sodomizing a male nursing home resident.  The 21-year-old was arrested following a week-long investigation into possible abuse on November 2nd.

Police say a co-worker witnessed an incident and immediately notified authorities.  Florence police say Mitchell-Hollingsworth is playing a crucial role in the on-going investigation by speaking with other residents.  “We are kind of letting them lead that part of it since they know their patients. We don’t want to cause any undue stress or trauma to any of the patients,” said Sgt. Greg Cobb with Florence Police.

 

WKYC reported the horrific death of James Dempsey, a decorated World War II veteran from Woodstock, Georgia.  An 11Alive investigation uncovered hidden camera video catching nursing home staff laughing while an elderly patient dies in front of them. The video was recently released as part of a lawsuit filed by the family.   Hidden cameras are an important way to prevent abuse and neglect and to prevent cover-ups like this one.

The incident happened at the Northeast Atlanta Health and Rehabilitation owned and operated by the national for-profit chain, SavaSeniorCare.  Attorneys representing SavaSeniorCare tried to prevent 11Alive from obtaining the video. They asked a DeKalb County judge to keep the video sealed and then attempted to appeal to the Georgia State Supreme Court. The judge ruled in favor of 11Alive and the nursing home eventually dropped its appeal to the state’s highest court.

Watch the extended deposition here where her story changes after watching the hidden video.

The video includes almost six hours of video court deposition from a nursing supervisor explaining how she responded to the patient before she knew the hidden camera video existed. The video shows a completely different response. SavaSeniorCare was made aware of the video in November 2015, but the nursing home did not fire the nurses until 10 months later.

In the video deposition, former nursing supervisor Wanda Nuckles tells the family’s attorney, Mike Prieto, how she rushed to Dempsey’s room when a nurse alerted her he had stopped breathing.

Prieto: “From the time you came in, you took over doing chest compressions…correct?”
Nuckles : “Yes.” 

Prieto: “Until the time paramedics arrive, you were giving CPR continuously?”
Nuckles : “Yes.”

The video, however, shows no one doing CPR when Nuckles entered the room. She also did not immediately start doing CPR.  The video shows the veteran calling for help six times before he goes unconscious while gasping for air. State records show nursing home staff found Dempsey unresponsive at 5:28 am. It took almost an hour for the staff to call 911 at 6:25 a.m.

When a different nurse does respond, she fails to check any of his vital signs. Nuckles says she would have reprimanded the nurse for the way she responded to Dempsey. She called the video “sick.”  When nurses had difficulty getting Dempsey’s oxygen machine operational during, you can hear Nuckles and others laughing.

Prieto: “Ma’am, was there something funny that was happening?”
Nuckles : “I can’t even remember all that as you can see.”

11Alive showed the video to Elaine Harris, a retired nursing professor and expert in adult critical care. “In 43 years in nursing, I have never seen such disregard for human life in a healthcare setting, is what I witnessed,” said Harris.

In the video, nursing staff repeatedly start and stop doing CPR on Dempsey. Harris says once you start doing CPR, it should not be stopped until a doctor makes the decision not to resuscitate.  “That is absolutely inappropriate. You never stop compressions,” said Harris.

The nursing home operators, owned by Sava Senior Care, declined interview requests.

State health inspection records show Northeast Atlanta Health and Rehabilitation continued to have a history of  problems after Dempsey’s death. Medicare records show the nursing home facility was cited at least two dozen times for serious health and safety violations, including “immediate jeopardy” levels, the worst violation. Medicare withdrew one payment and the facility has been fined $813,113 since 2015.  The facility has a one-star rating from Medicare, the lowest score the agency can give. The nursing facility remains open today.