South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

Protection and Advocacy

Posted in Abuse and Neglect, Advocacy

If you have a loved one in a nursing home in South Carolina, we encourage you to take a look at the Protection & Advocacy website. This link will take you to a page where you can see P&A Inspection Reports of Community Residential Care Facilities and Team Advocacy 2013 – 2014 Annual Report. You can look up facilities by county. This tool can be useful in determining where to place a loved one and it can also be useful in seeing if you and your family should reevaluate your nursing home choice.

 

 

Hidden Camera Records Neglect

Posted in Abuse and Neglect, Staffing, Trial themes

Junetta Jenkins, Jasmine Franco, Champagne Anderson, Savannah Harding, Binita Dahal, and Faye Aguillon are facing charges of neglect after one resident’s son called to complain about the care his father was receiving. The man’s father, a double-amputee who was paralyzed and had cognitive loss, was at Blossom North Nursing Home where he was continually neglected, as shown by hidden camera footage where nurses and aides repeatedly failed to give the patient his medication, check his vital signs, and left him immobile for lengthy periods of time. Investigators also believe that the nurses and aides falsified the patient’s chart to cover up their negligence.  See full article here.

 

Politicians Protecting Industry over Citizens

Posted in Advocacy

One 86 year old is fighting for change, but her attempts are being denied by the state Congress. Fern Horton, an 86 year old Oklahoman, has refused to back down from a bill which would help regulate nursing homes by requiring more staff and more oversight of that staff. However, the Long Term Care and Senior Service’s committee refused to even hear the bill.

Wes Bledsoe, founder of A Perfect Cause, a nonprofit focusing on improving long term care, said, “Here we are with a bill that would protect our loved ones, it would save lives. And yet, the bill’s being denied a hearing in public?”  Horton herself agreed with Bledsoe’s sentiment, asking the question, “What does the body count have to get to?”

Representative David Dank, chair of the committee, said that he doesn’t think the current bill is the “right form”. He said he looks forward to conducting an interim study, meeting with all parties, and perhaps reintroducing the bill with some changes. For her part, Horton was dissatisfied with that response. She said she would fight until she can no longer fight anymore.  See article from Fox23.

 

Forensic Accounting of Theft

Posted in Staffing, Trial themes

Joyce Ziehli was charged last year with six counts of felony theft for allegedly stealing $850,000 from the nursing home where she worked. The New Glaurus Home hired a forensic accountant to see exactly how much Ziehli had stolen while she was an employee there, a ten year span. The accountant said the amount was $850,000, however, Ziehli’s attorney has serious doubts about the veracity of the accountant’s report. He hired an accountant, Dennis Kleinheinz, to investigate how much was stolen and disagrees with the other report on the final amount. Kleinheinz takes issue with several aspects of the other report, including the use of electronic transfers which he says there are no record of and the other report claims to total $91,288 in electronic transfers and checks written to credit cards. He also takes issue with the idea that Ziehli was extracting money solely for personal use. He says that more than $250,000 of the total taken was used for professional expenses and were part of her job. In this case, it seems that to find out exactly what went on with Ziehli’s embezzlement, both sides must follow the money. The real question is, what happens when the money leads two different accountants to two different conclusions?

The Role of Ombudsman

Posted in Advocacy, Regulatory enforcement

An Ombudsman is someone who investigates complaints against nursing homes and advocates for resident’s rights.  In New Mexico, the state Ombudsman has the power to impose penalties on nursing homes for noncompliance. In December, 2013, that’s exactly what one Ombudsman did.

Sondra Everheart, long-term care Ombudsman issued a fine against Preferred Care Partners Management Group for $23,500. The Group manages two nursing homes, one of which, the Casa Real Healthcare Center, had an administration which were engaging in “obstruction and intimidation” according to Everheart. Comments by the administration at Casa Real were that employees should not talk to the Ombudsman and there were other problems as well, including lack of communication of relevant information.

The initial fine of $23,500 was lowered to $3,500 after the Group worked with the Ombudsman and agreed to change their policies. The new policies reflect cooperation with the Ombudsman rather than intimidation. They should also help to ensure that the Ombudsman gets documentation and relevant information in a more timely manner.  See full article here.

 

Awakenings Initiative

Posted in Advocacy

The Star Tribune reported that the Ecumen nursing care organization has been trying an experiment called the Awakenings Initiative since 2009. The program is designed to reduce use of anti-psychotic medications for patients who exhibit behavioral problems but aren’t diagnosed with psychosis. Many nursing homes and elderly care facilities use anti-psychotics to control patients’ behavior. Where memory loss makes patients confused and agitated, aggressive behavior can pose problems for caregivers. To help mitigate how aggressive a patient is behaving, drugs can be used to calm the patient down or sedate them. This practice, while common, carries with it many risks for the patient and their loved ones. The use of anti-psychotics on elderly patients results in an increase in risk of death for those patients. The sedation from those drugs can result in added confusion and memory loss, contributing to the cycle of dementia.

The Awakenings Initiative uses a behavior and environment centric approach to combat aggressive behavior from their patients. They’ve experienced remarkable success with the program, and are continuing to implement it even though the initial funding for the program has run out. They were able to reduce the use of anti-psychotics for patients not diagnosed with psychosis by 97% across the 15 nursing homes they operate. This results in a savings of $200,000-$400,000 a month for Medicare and Medicaid. The before and after use of anti-psychotics among patients who don’t need them is staggering, but the crazy part is that the Awakenings Initiative is not a radically different course of treatment. It simply revolves around patient care. Take this story, for example, which illustrates the Initiative’s approach:

“Barbara Melby chose the memory care unit Ecumen Parmly LifePointes in Chisago City for her husband, Harlan, last year because it aims to avoid stupefying medications to control his unruly behavior. Harlan, 74, has suffered from Parkinson’s disease for more than a decade and developed advanced dementia in the last two years. He had been taking trazodone and Xanax for severe anxiety, but they provided little relief; he wandered away more often and became more aggressive as he lost his ability to recognize her. After he moved into the nursing home 14 months ago, the staff noticed that loud noises and busy activities made him fearful, so they provided a quieter place for him at the edge of activities and gradually reduced his meds. Melby said he now recognizes her at times.”

Or this one:

“She gave an example of one of her former patients, a woman in her 80s with severe dementia who tore at her hair and repeatedly banged her head, complaining of hearing dead babies in the room. A staff member eventually figured out that she was delusional and misinterpreted the squeaky wheels of a medicine cart as wailing babies. “The answer for her wasn’t medication. It was WD-40 on the wheels of the medicine cart,” Phillips said.”

Or this one:

“Maria Reyes, who oversees training and management of the Awakenings programs, cited a similar case. She recalled a male patient who had a habit of urinating indiscriminately around the facility where he lived. The staff eventually learned that he’d lived on a farm and used an outhouse his whole life; he wasn’t sure where to go at the nursing home. So they decorated the bathroom door to resemble an outhouse, and that solved the problem, Reyes said.”

These ideas aren’t crazy. They don’t require expensive equipment or prodigies to diagnose and treat patients. They simply require listening to the patient and understanding that the patient’s environment is important. Instead of shoving anti-psychotic medications down a non-psychotic patient’s throat, which can have a whole host of negative side effects including increased risk of death, the caregivers could simply try to understand the patient and listen to what they’re saying. This kind of idea, while not radical in the course of treatment, is a radical cultural shift for caregivers in long term care. While it may be easier to simply prescribe a patient a medication which will keep them so sedated they can’t do anything, much less pose a behavioral problem, more nursing homes could take the approach that Ecumen has found to be so successful – actually caring about the patient and thus, caring for them.

 

Administrator Blames Lack of Staffing

Posted in Advocacy, Staffing

The Halifax Courier reported that Faheza Simpson, manager at Elm View Nursing Home in Halifax, told juries in 2011 and 2013, as part of a case where she has been charged with neglect, that she was not a part of the problem. As manager, she contributed the lack of communication regarding patients’ pressure sores to the fact that the nursing home didn’t have internet and thus the forms to be completed had to be sent through the postal service, which caused a delay.

She also denied that she “accepted the system” of poor care, saying, “I personally wasn’t happy because I was trying to do my best with whatever was available at the time… It was not my standard to accept that kind of care… it was because we were short of staff.”

Then why didn’t she hire more staff?

Confession then Denial

Posted in Abuse and Neglect, Advocacy, Staffing

WLKY reported that David Satterfield confessed and then recanted to killing one woman and injecting two others with fatal doses of insulin in 2007. Marcelline Vale died a month after being found with low blood sugar after he injected her with a fatal dose of insulin according to Satterfield’s statement. Vale and the two other women he confessed to injecting were not diabetic. Though all three are now dead, investigators haven’t been able to prove a link between the two other deaths and an insulin injection.

Satterfield says he did not inject another woman who died following the same circumstances as Vale later that year. When asked why he committed the crimes, Satterfield said he was high on prescription meds, and that there was no reason. Satterfield is terminally ill, has no home or job, and said during his interview that he wanted to turn himself in because he wanted “a place to stay and eat and not have to worry about life”. He later recanted his confession, saying he and two other employees were on a smoke break when the women were injected. Satterfield was arrested and charged with Vale’s murder.

 

Failure to Give CPR

Posted in Abuse and Neglect, Advocacy

Around lunchtime, a resident at the St. Benedict’s Senior Community walked to the dining room. The resident began feeling dizzy. When nurses came to check on the resident, she was nonresponsive. They checked for a pulse and found one, so they moved her to the back of the room and left her alone.  Ten minutes later, they checked on her again. This time, there was no pulse. Rather than performing CPR, as the resident’s medical directive indicated, two nurses let her die. The two nurses were suspended and then fired. The supervisory nurse was retrained on policies and procedures. The nursing home was found to be responsible for the resident’s death, to which they objected, but did not appeal the decision.  See full article at StarTribune.

 

Who is Protecting the Residents?

Posted in Abuse and Neglect, Advocacy, Staffing

Nursing home administrators have no obligation to tell residents and staff that they may be living or working in the same residence as registered sex offenders. This is a problem because sex offenders attack vulnerable people – of which nursing homes have plenty. Many of the nursing homes have problems with residents attacking other residents, some of those doing the attacking are sex offenders. While neighbors have to be notified if a sex offender moves into the neighborhood, people living under the same roof as these offenders are completely unaware.  See excellent video from WKYC.