KRISTV news of Corpus Christi, Texas reported that a family filed a lawsuit against La Hacienda Nursing Home after their father was not properly cared for after sustaining a knee injury. The family says the facility’s neglect caused the injury to become infected which resulted in the amputation of the leg. The family came to a settlement with the nursing home outside of court, but it seems that the facility’s issues do not end there.

Recent research on the nursing home determined that the Department of Aging and Disability Services filed a claim on the nursing home in recent months that lists several state violations.  It states that in the most recent inspection of the facility, the nursing home exceeded the allowable medication errors, which is five percent. The facility was also sited for not getting food from approved places and failed to store, prepare, and administer food in a safe and sanitary way. Lastly and most relevant to the recent settlement, the facility was sited for not having a program to keep infections from spreading. Perhaps that is why their father lost his leg.

Overall, this report scored the facility as a 50 out of 100 which is extremely low considering the average nursing homes that accept Medicaid and Medicare score an average of 66 out of 100. The nursing homes administrator, James Baker, defended the facility claiming that many of the violations were “minor” and had all been addressed with the exception of one. When asked about the low scores he claimed, “We work on that rating year long. We try and improve it everyday.” Obviously his facility’s efforts are not doing enough.

Austin Weekly News reported on the numerous violations of the standard of care at Columbus Manor Residential Care Home.  Columbus Manor was not in compliance with 11 federal requirements for nursing homes that participate in the Medicaid program, according to an Illinois Department of Healthcare and Family Services notice.  The violations – based on surveys the state health department conducted at the facility in April, July and August – involved resident rights, quality of life issues and the physical environment, among other problems.

"The August survey cited the nursing home staff for failing to supervise one resident – a registered sex offender with a history of sexual aggression. The resident left the facility without permission, was hit by a car and admitted to the hospital for a knee fracture in February. The facility failed to create a care plan for the resident before and after the incident to prevent unauthorized departures from the nursing home, according to the August survey."

The Illinois Department of Public Health was also in the process of revoking Columbus Manor’s license – which allows it to operate as a long-term care facility – due to a previous incident.  On March 17, 2010, a nursing home administrator yelled in an "intimidating manner," used profanity toward the investigators, threw medical charts and documents, and threatened the Illinois Department of Health with "repercussions if the department wrote up violations," according to the notice of license revocation.

The administrator ended the mandatory meeting and ordered the investigators to leave the facility – an automatic license revocation.  However, for some unknown reason, the license was not revoked.

 

The Leaf Chronicle reported the $740,000 fine issued to Spring Meadows Health Care Center in Clarksville, Tn.  The U.S. Centers for Medicare & Medicaid Services fined the nursing home for various violations of federal regulations. The inspection report by the Tennessee Department of Health lists a number of minor infractions and five serious ones. The most significant infraction was lack of supervision and other precautions that led to a resident repeatedly suffering serious injuries from falls.

The report said that one of the 20 residents surveyed fell eight times between February and July, suffering injuries that include a chipped tooth, a broken nose and lacerations that required sutures.  One section of the report alleges instances of verbal and physical abuse perpetrated by residents who weren’t properly handled by the staff.

It also describes an incident where a resident was transferred to a different room when she complained that the staff wouldn’t give her neighbor a bath or change the neighbor’s clothing. 
 

The Republic reported the lack of penalty after a Honolulu nursing home failed to investigate an incident where an employee sexually assaulted four residents.  The facility "escaped any federal sanctions even though administrators failed to thoroughly investigate allegations of abuse there."

Apparently the Centers for Medicare and Medicaid Services deferred to state regulators who cited the facility but did not recommend any disciplinary actions. The aide, Mark Genetiano, pleaded guilty last year to pinching the four womens’ breasts and was sentenced to one year in prison.

 

Press of Atlantic City wrote an article discussing the dismal record of New Jersey nursing homes. Seven New Jersey nursing homes received the lowest quality ratings from the federal government last year based partly on state inspections in 2009 and 2010. Inspection reports show that residents in the worst-rated homes live in dirty conditions, endure verbal and physical abuse, and are neglected.

Hundreds of violations of rules that govern quality of care, safety and sanitation were found by inspectors during the past two years at the 60 nursing homes in Atlantic, Cape May, Cumberland and Ocean counties. The reports are used by the U.S. Department of Health and Human Services to develop consumer ratings of one to five stars for nursing homes. The majority of area facilities – 65 percent – are rated three stars or lower, federal data show, and half are in the bottom two levels.

A review of more than 1,800 pages of New Jersey Department of Health and Senior Services inspection reports from 2009 through April 2011 for 10 nursing homes showed that residents are routinely found living in dirty conditions, endure verbal and physical abuse, and are subject to neglect. Other violations include staff giving out the wrong medications, residents being strapped into wheelchairs and ignored for hours, theft, untreated infections, falls resulting from fragile residents being left unattended, and fire- and building-code violations.

State reports provide details of problems found during inspections. Some residents live in fear of reprisal if they complain about conditions.

A recurring theme was a failure to investigate or report incidents of abuse. Another recurring problem was failure to properly administer medication.  The medication error rate is not supposed to exceed 5 percent. A November inspection found an 18 percent error rate at South Jersey Extended Care. Our Lady’s Residence had a 14 percent error rate. Lincoln Specialty Care was at 9 percent, and Arcadia was at 8 percent. In one case at South Jersey Extended Care, a resident was supposed to get morphine every three hours for rectal pain, but went days without it because there was none.

A nurse and an aide allegedly told a resident who wanted help getting out of bed frequently overnight that she could not get up before 4 a.m. The inspection report states the staffers threatened to take away her wheelchair, withheld snacks and threatened to keep her in bed longer if she complained. The report states the resident shook in fear in the presence of the nurse and aide.

There are 367 nursing homes in New Jersey charging an average of $250 per patient per day, said Paul Langevin of the Health Care Association of New Jersey, a trade group of 185 homes.  Most homes are for-profit businesses run by companies that have multiple facilities. Costs of more than $90,000 per patient per year are often paid through Medicare and Medicaid, so tax dollars pay much of the bill.

KAALtv reported serious problems with the quality of care at St. Mark’s Lutheran Home in Austin.  Many family members have complained.  The family council –which is made up primarily of family members of residents in the nursing home–are saying quality of care has been a battle with the facility for far too long.

"We’ve continually come to the board and the management, and it seems quite often to us some of the same problems keep reoccuring," says President of the Family Council Dick Heuton.

"St. Marks basically is considered a low performing below average facility," says Jean Mueller, regional ombudsman for the state.

According to Medicare’s website, St. Mark’s Lutheran Home was inspected in April and had 11 deficiencies. Inspectors found they failed in areas of quality care and nutrition.  Inspectors found evidence they failed to prevent or promote the healing of bed pressure sores and they failed to ensure the unpasterized eggs, served to residents, were cooked properly. Another major deficiency is staffing or lack their of, "we have some really good nurses and aids and support staff here, but they just don’t have enough of them," say Huebner.

"A lot of time after the state inspectors have been here, what’s happened is they get a little better for a little time then they just fall right back off, then we’re in the same boat we were in before, " says Huebner.

 

 

 

Caymanmama.com had an article about problems found at Mustang Manor Assisted Living Center including 27 nutrition and sanitation-related issues..  The Oklahoma State Department of Health (OSDH) found problems with on-site cleanliness, nourishment, and the overall welfare of the elderly residents. Reports show the Mustang Manor has been cited for numerous unspecified violations of safety and health in the last two years. These issues amounted to an excess of $35,000 in OSDH-issued penalties. 

Beyond claims of safety and health hazards at the nursing home, officials from the Mustang Police Department have received complaints of criminal activity at the establishment. According to Mustang Police Capt. Willard James, “We received a call that a resident had actually written checks to an employee of the business and had them cashed to have the money returned to her, and she had not received those funds.”

Often the two major areas where a nursing home can cut operating costs to improve profits is staffing and nutrition.  Many nursing homes cut staffing especially of RNs and LPNs to make more money for their corporate owners. 

Nutrition and sanitation are very important to prevent pressure ulcers and infections.

The Post-Tribune had an incredible article about the horrible conditions at Northlake Nursing and Rehabilitation Center. Complaints filed by residents and their family members depict horrors that sound unbelievable in a modern health and healing center. Indiana State Department of Health finally suspended the nursing home’s license.  The state issued an emergency closure order on Feb. 1 for the home owned by Eric Rothner and his Evanston, Ill.-based company, Extended Care Clinical, which own three other nursing homes in Lake County and more than a dozen in Illinois, Nebraska and Ohio.  The story of Northlake’s demise can be told through its residents and their families and staff, as well as state regulators and ombudsmen and physicians who have treated patients there.

Of the nearly 100 patients residing at Northlake in early January, fewer than 12 remain. The state-supervised relocation is winding down and more residents leave daily for new homes in other long-term care facilities.  At least nine resident and family-member lawsuits and numerous state inspection surveys tell a story involving repeated evidence of broken care.

The complaints and lawsuits point to repeated breakdowns in patient care. They point to high turnover, not only at the level of low-paid certified nurse assistants, but also among staff nurses and the top executive positions of administrator and director of nursing.

"He buys homes cheaply that are in terrible shape. They (Rothner’s Northwest Indiana nursing homes) have a certain number of beds to fill and don’t have high enough census to pay their bills. They start getting desperate and are not selective about accepting the residents they take, people they have no business accepting, just to fill the beds."

Local long-term care ombudsman Christopher Herrmann said Northlake wasn’t always a problem home. He said when a Rothner predecessor company, Care Centers Inc., bought Northlake in 1995, he hoped for a good turnaround.

But once the state began issuing Nursing Home Report Cards in 2002, Northlake recorded poor scores. Herrman, of Northwest Indiana Community Action Corp., said Northlake staff expressed shock at those scores, complaining Indiana was tougher than the Illinois inspectors who survey Rothner’s nearly 20 homes there.

In August 1995 Rothner purchased Northlake from Atrium Living Centers of Indiana. Its current administrator, Crystal Wray, took over in March 2009, shortly after the U.S. Centers for Medicare and Medicaid Services, the federal agency that administers the Medicare program, named Northlake a Special Focus Facility.

CMS confers that nursing home "hall of shame" designation to fewer than 150 of the nation’s 15,000 nursing homes annually.

Arlene Franklin, the state’s long-term care ombudsman who advocates for nursing home patients for the Indiana Families and Social Services Administration, said she wasn’t surprised to see Northlake close.  "They had a bad record and couldn’t return to compliance," Franklin said. "Since I’ve been state ombudsman I can only recall four or five other nursing home closures. Normally when a home is cited they work really hard to get back into compliance, but the ones that closed never did."

Rothner said state health regulators have it in for him.

 

There were several articles about the lack of investigation by Texas regulators on nursing home complaints.  The Star-Telegram ran an article.  MySanAntonionews.com ran article.  Also American Statesman had one too.

Interviews with families and advocates and a review of thousands of pages of public records by the San Antonio Express-News show some of the city’s most frail and vulnerable residents are suffering at the hands of their caregivers. Yet state officials allow troubled nursing homes to continue operating with little or no penalty.

The lack of oversight comes at a human cost. Elderly residents were left for hours in their own urine and feces. Infestations of cockroaches and rats plagued some facilities. Employees yelled insults at residents and handled them roughly. Nursing home staff stole medication and administered the wrong drugs to residents. State inspectors found dirty feeding tubes and broken medical equipment.

The state received nearly 16,200 reports of poor treatment last year in Texas, but most — about four out of five — were unsubstantiated by investigators, who often arrive at the nursing home weeks after receiving the complaint.   When investigators do cite facilities for serious problems, nursing home operators rarely face sanctions. In some cases, the state repeatedly threatened to suspend or revoke the licenses of facilities with chronic problems, yet Texas rarely took action against those nursing homes. Often, a facility promises to do better, state regulators back off, and problems crop up again in a troubling cycle.

Meanwhile, serious complaints against nursing homes have increased in Texas . Complaints about problems that put residents in “immediate jeopardy,” the most serious type of complaint, rose 26 percent since 2006, to more than 950. Complaints of “actual harm,” the second most urgent type of complaint, rose by 10 percent since 2006, to nearly 6,300.

Faced with alarming delays in investigating nursing home complaints, the state is creating teams to speed up scrutiny. State nursing home investigators blew their deadlines to investigate complaints of "high potential of harm" against residents in 66 percent of investigations in fiscal 2009.   In such complaints, mental, physical or psychosocial harm is possible, though not imminent, and an investigation must be initiated within 14 days. 

In response, the Texas Department of Aging and Disability Services will put together teams to speed the state’s response. Next month, the department will begin to hire 35 new investigators.

Complaint investigation teams are being set up statewide. Made up of nurses, nutritionists, social workers and general investigators, the teams will be dedicated solely to conducting investigations of complaints and self-reported incidents.

This month, the department plans a two-week blitz to investigate 1,550 complaints at more than 300 facilities, a department spokeswoman said.

The department regulates 1,196 nursing homes statewide and investigated 16,200 complaints and incidents last year.

 

The Charelston Gazette had an interesting article about a former employee of Broadmore Estates who has sued the Putnam County assisted-living facility for allegedly overlooking alcohol and substance abuse by its employees, and ignoring state regulations for drug distribution.  Lynn Gomez of Elkview filed the lawsuit in Putnam County Circuit Court on against Broadmore and the facility’s director, Delores Miles.  Gomez alleges in her lawsuit that she was ostracized and lost her job because of several complaints she brought to Miles about drug abuse and employee conduct.

Gomez was hired in February as a registered nurse and as director of wellness at Broadmore’s assisted-living facility in Hurricane.    When she began working, Broadmore’s patient charts and medical records were in disarray, the facility was understaffed and staff members did not follow state regulations for drug distribution.

She also alleges that, within her first few weeks at Broadmore, she was approached by a staff member and a pharmaceutical representative about a nurse who consistently came to work drunk or with alcohol on her breath.  Gomez alleges that the nurse approached her and stated "Lortabs do nothing for her and that she had already had four Percocet that day."

Gomez states that she approached Miles about the woman’s statement and was told the nurse "had been on drugs for a long period of time, and could practice while on the medications." She also was told the nurse had been off work for a medical condition, the lawsuit states.

Gomez alleges that the nurse falsified patient charts, saying she had administered drugs that she actually had not, and that Miles falsified documents to reflect that the drugs had been properly administered and were accounted for.

The nurse eventually was fired after an outside pharmaceutical representative discovered that the nurse had falsified drug distribution records, the lawsuit states.

Gomez wants back pay, compensation for emotional and mental stress and attorney’s fees.