The West Virginia Gazette had an article about the history of poor care provided at Heartland of Charleston in West Virginia. Federal authorities revoked its' Medicare and Medicaid funding in September after inspectors cited the home for several serious violations after the corporate owner/operator failed to fix the deficiencies that state inspectors found in June.
"The violations listed in the initial 156-page inspection report ranged from administrators failing to keep notifications of procedures and nurse availability posted to more serious cases where one patient bled profusely from a pressure sore after nurse's aides failed to check whether a blood-clotting test had been performed. A supplemental report lists several instances where the home's administrators failed to properly investigate allegations of staffers abusing patients, including one case where a patient had accused two nurse's aides of beating him in a shower room."
Other deficiencies listed in the inspection report included:
A resident, labeled as a fall risk, was found face down on the floor six hours after she was admitted. Nurse's aides had placed a fall mat on one side of the woman's bed.
One resident had an unnecessary catheter for more than two months, while two more residents were not given proper treatment after doctors had declared them incontinent. The inspector found that one of those residents had been sleeping on a bed with a large wet ring stretching across the bottom sheet.
Some residents were taking medications they did not need. According to the report, nurses continued to give one resident "sliding scale" insulin doses despite a pharmacist's recommendation to stop. The pharmacist noted that the resident's blood sugars were in "excellent control, " and detailed the facility's need to closely monitor the resident's future insulin intake. Staff had not checked the resident's hemoglobin levels in months, according to the report.
Nurses found one resident on the floor at least five times in two months. In January, the elderly patient fell twice in a span of about 12 hours. Staff labeled some of the falls as "attention-seeking behaviors," according to the inspector's notes.
Inspectors found that the home's medications were not properly labeled.
One resident lost seven pounds in three days because staff had failed to provide dietary supplements a doctor had prescribed.
A resident with a right hand muscle contracture (a permanent shortening of a muscle or joint) was not fitted with a device designed to help minimize the loss of range of motion. The resident's care plan noted a need for the device in February -- four months before the June inspection.
Nursing staff took 10 to 20 minutes to answer several residents' call lights.
One nurse's aide was fired after intentionally unplugging a resident's call light. Administrators did not report the incident to Adult Protective Services.
A resident known as No. 228 was neglected. The inspector could see dried blood on a cut above the 76-year-old woman's left eye, which was still swollen and bruised from a fall she had while trying to pick up a bag of birdseed at about 2:30 that morning. The woman's nursing notes revealed that she was admitted to the facility at 8:30 p.m. the previous evening. A doctor wrote on her admission form that she suffered from dementia and had a history of falling.
The fall earned her a trip to the emergency room, where doctors assessed, cleaned and repaired her head wound, according to the inspection report. She was back in her bed at Heartland by 6:30 a.m. with a doctor's instructions for follow-up care.
Since 2006, federal authorities revoked Heartland's Medicare and Medicaid funding three times and have fined the home a total of $232,375. Toledo Ohio-based HCR Manor Care, Heartland's overarching corporate owner, operates hundreds of nursing homes across the country and lists assets of more than $8 billion. The company, which itself falls under the ownership of equity giant Carlysle Group, has attracted criticism for reportedly hiring too few staff at low pay in order to maximize earnings.
