Do nursing homes ignore abuse?

Michael Owens of the Bristol Herald Courier wrote an article about National HealthCare-Bristol ignoring the obvious warning signs of abuse including those acts done by James Wright who was recently convicted of sexual assaults.

The article talks about one resident who rolls into a fetal position and reaches with both hands between her legs and around her back and shifting hands from side to side along her inner thighs have left her flesh tissue thin, red and raw as if to block sexual advances. The actions are the psychological remnants of a sexual assault by former employee and convicted serial molester James Wright.

The traumatized woman is among the dozen patients that state detectives say were sexually assaulted at NHC between February 2000 and August 2007.  State detectives have linked him to seven attacks. State medical licensing documents also tie Wright to a later rape at another assisted-living facility, where he took a job immediately after leaving NHC.

Somehow, the abuse continued for seven years even though there were red flags.

The first showed up in February 2000. A resident accused Wright of touching her inappropriately, and then warned him to stay out of her room.  In the following years, accusations by three other patients sent officers from multiple law enforcement agencies looking for an unknown assailant.

NHC contends the attacks could have been stopped had only the abuse been reported up the chain of command to the home administrator.  Employee records and witness accounts suggest that NHC-Bristol management also might have harbored concerns about Wright.   Five female patients complained of being attacked in the months leading up to Wright’s departure. Three times, co-workers blamed Wright almost immediately.

However, instead of firing him or reporting him to the authorities, NHC allowed him to resign with favorable recommendations amid a crescendo of sexual assault complaints. Wright jumped to a similar job at nearby Grand Court Assisted Living immediately leaving NHC.  A solid recommendation by then-NHC Director of Nursing Elizabeth Anne Franklin helped him land the job, internal Grand Court documents show. The reference-check report, penned by Grand Court recruiter Sue Huff, does not mention any warning that Wright had been the prime suspect in a sexual assault case just days before he applied for the job.

These assaults, and the manner in which the complaints were handled, illustrates the skepticism that surrounded abuse claims, and the problem of nursing homes failing to investigate or worse, covering the abuse up.

 

NHC's CNA sentenced to 60 years

The Bristol Herald Courier had an article on James Wright, the NHC CNA who raped multiple residents.  Wright blamed his four victims for the sexual assaults they suffered according to a psychological evaluation. The evaluation was court-ordered to determine Wright’s eligibility for a sexual offender treatment program. The test has roughly 1,200 questions that focus on sexual desires and past relationships.

The evaluation describes the man who once fed, bathed and clothed National HealthCare’s elderly residents as a manipulative hedonist with tendencies of voyeurism and exhibitionism. It also ranks his personality in line with the average rapist and molester.

“He holds the victims responsible ... because the accuser wanted and liked the sex play that happened,” the evaluation states.

“This is no doubt an indescribably despicable criminal act,” Judge Kirksey said before issuing the 60 year sentence. “Certainly, as a certified nursing aide, you understand the position of trust ... you were placed in by these women and by [their] families.”

During the evaluation in March, Wright alluded to the technical significance of his plea.

“I was charged with four counts of groping,” he told the test administrator. “I did not hurt anybody. They were the mental patients. I made an Alford plea on the advice of my counsel. I did not plead guilty.”

“His ... evaluation shows that he preys on people who are helpless,” Wolfe said, noting that each victim had been diagnosed with dementia or Alzheimer’s. “He picked out victims that he didn’t think would be able to tell on him.”

Since Wright’s arrest last year, NHC-Bristol supervisors have been accused of both ignoring and failing to report suspected patient abuse. A state licensing board has fined and reprimanded former Director of Nursing Elizabeth Anne Franklin. Current home Administrator Charlotte Wilson and Nursing Supervisor Helen Roberts face possible sanctions against their licenses.

 

 

NHC's DON threw complaints about abuse into trash can

Michael Owens has a follow up article to his recent articles about how NHC cover uped and protected a sexual predator and allowed him to continue working in the health care field despite being required by law to report abuse.  This is a fascinating story that needs to be told.  It is a perfect example of how corporate greed conflicts with quality care of nursing home residents.  Obviously, Mr. Wright will go to jail but so should the Administrator and Director of Nursing who let this predator roam the halls of nursing homes.  It will be interesting to see if law enforcement and regulatory agencies do anything about this tragic case.

The article explains that the DON Anne Franklin not only ignored four National Healthcare Bristol nursing home employees who filed written accusations that Wright was sexually assaulting patients but actually  threw at least two of those complaints into a trash can.   Was this a cover up or just the corporate policy so there wouldn't be a paper trail?

 Luckily, CNA Cynthia Aldrich, lashed out in a fit of frustration at the nursing home’s on-call doctor, urging him to do something.  More than a month later, James W. Wright would leave the nursing home, but not before one more nurse complained to supervisors that she twice caught him sexually abusing a blind woman patient.



 

NHC covers up molestation by CNA

Michael Owens of the TriCities.com website reported a story about another sexual assault of a nursing home resident by an employee nurse.  The article discusses how a co-worker, Patricia Davenport, reported the employee molesting a resident on two different occasions but was told  she was mistaken by NHC (National HealthCare Corp.).   She quit after the complaints were ignored.

Davenport then told the Office of the Attorney General of Virginia that she witnesses the same aide molesting two different nursing home patients.  Davenport said the first time she stumbled upon the abuse of patients was in August 2007. The woman’s shirt and bra had been shoved high on her chest. A nurse’s aide was standing behind the wheelchair, and he was reaching around to fondle the patient’s breasts. Later that same month, Davenport said, she caught the same aide fondling a blind patient.  That aide, James W. Wright was indicted on four counts of aggravated sexual battery. Each count stems from the investigation into the treatment of a different patient from 2000 to 2007.

National HealthCare Corp., runs the Bristol nursing home as well 75 others in Tennessee and other eastern states.  Virginia Department of Health Professions records show that Wright still holds an active license to work as a nurse’s aide.  The abuse was not a secret among nursing home staff.  “When I talked to the rest of [the nurses], they said this has been going on for years,” Davenport said.   Davenport said she complained to her supervisor.  “You look at those people every day in the face knowing they’re getting abuse and you can’t do anything because nobody’s got your back,” Davenport said. “I don’t want to go back to nursing.”

A second article discusses additional abuse by Wright at the Brookdale Senior Living-Grand Court Bristol nursing home, where the aide accepted a job after passing the criminal background and job reference checks.  Although nursing aides said they witnessed and reported sexual abuse by Wright to NHC officials, NHC did not pass along any of that information to Grand Court.  In all, eight people from both nursing homes have told investigators they were groped, fondled and sexually assaulted by Wright between July 2003 and May 2008, according to documents filed by the Virginia Board of Nursing.   Nursing board documents show that seven NHC patients complained of being sexually assaulted while under Wright’s care.

Despite those complaints at NHC, the aide arrived at his new job in September 2007 with flawless references, said Holly Botsford, a spokeswoman for the Chicago-based Brookdale Senior Living, which runs 548 homes across the nation, including Grand Court Bristol.  “None of [the checks] indicated he had any previous employment or character issues,” Botsford said.  A Grand Court patient was sexually assaulted the following May, according to Virginia Board of Nursing documents.

A pair of former NHC nurses said the nursing home’s management routinely dismissed patient and nurse allegations against Wright.   It was in 2003 that former NHC nurse Diane Lewis reported a patient’s complaint of being touched inappropriately. A staff director did ask the patient about the complaint, but the investigation ended there.  Twice in August 2007, then-nursing aide Patricia Davenport complained that Wright mistreated two patients.


 

NHC ignores sexual predator employed at their facility

Now I understand why National HealthCare Corp, (NHC) is so desperate to protect their massive profits and limit the amount of damages for residents abused and neglected in their nursing homes. The Nashville Scene had an article about a sexual predator being employed and allowed to roam freely in a NHC run facility for over SEVEN years.

In the nursing home, NHC staff say a predator stalked the elderly in its halls.  They say that for nearly a decade, he fondled, groped and may have even sodomized patients—some of whom couldn't walk, speak or see.   Affidavits, an investigator's memo and other documents obtained by the Scene identify the man as James W. Wright, a nurses' aide.   Despite repeated complaints from fellow employees, managers at the NHC Bristol facility allowed him to stay on the job.

Wright's co-workers were bewildered by what they describe as management's lackadaisical attitude toward the known abuse.  Many left in disgust.   Wright only resigned in 2007, several months after a Bristol police investigation of the home.   He was not even fired or reported to the Board of Nursing by NHC when the investigation found evidence to support the complaints.  This allows him to get rehired at another facility and continue preying on our elderly citizens.  He left NHC and began working for another nearby senior-living facility, Grand Court Bristol.  During an initial visit to Grand Court, executive director Libby Bailey was "unavailable". But when a reporter returned later that day, Bailey was expecting the visit. She read from a prepared statement and refused to answer questions.

"I have just become aware of some allegations of a legal situation involving one of our associates from his previous place of employment and he's going to be terminated" pending the outcome of an investigation, she said. "During the person's employment here, there've been no negative reports or issues related to his work."

As the complaints threatened to become public, however, pressure was applied to NHC on the victims' behalf. It is not known how much NHC has paid to keep the allegations against Wright quiet. But sources say several cases were settled before they ever went to court.

The first complaint against him came in early 2000, according to a memo written by private investigator Lloyd Emmons, a former DeKalb County Sheriff and Tennessee trooper. The daughter of a resident we'll call Emma—to maintain the privacy of alleged victims, the Scene has changed their names—noticed her mother became agitated whenever Wright was around. Emma was suffering from the early stages of dementia, but was reportedly still lucid.  Emma would swat defensively at Wright, according to her daughter.  She also complained that Wright "fingered me and he hurt me." The daughter reported her concerns to Charge Nurse Helen Roberts, but said the nurse defended Wright and persuaded her not to ban him from Emma's room.  After seeking counsel from her pastor and Emma's private sitter, the daughter resolved to have Wright banned from the room. Emma's complaints stopped.

 

 

Not long after he was removed from Emma's care chart, two aides came forward with more accusations against Wright.   As they were folding bibs at a desk, they said, they saw Wright pushing a resident, "Delores," in a wheelchair to the dayroom.   Delores had limited speaking abilities and could not walk on her own. The aides claim Wright's arms and hands were draped over her breasts as he pushed her down the hall.

Later, he and Delores left the dayroom for her own quarters.   In an affidavit, an aide testified that she heard Delores "screamin' and hollerin' " from her room. She entered to find Delores sitting on the toilet, pointing at her genitals and saying over and over, "He hurt. He hurt." Wright was standing over her.  She filed a report with Charge Nurse Roberts, and Wright was banned from caring for Delores by management.  There was never an investigation of the incident, even though it is required to report allegations of elder abuse.  She left NHC soon after.

The next incident came in 2003.   Aide Diane Lewis was working the first shift;  Wright was her second-shift relief. They walked together down the hall, checking in on patients and exchanging information.  That's when a male resident called Lewis into his room.  "He called me in and said, 'I don't want that boy taking care of me,' " Lewis claimed in an affidavit. "And I said, 'Why?' And he said, 'Because he sticks his finger up my butt.' I went straight up and wrote a report on it."

Lewis filed the report with director of nursing Evelyn Nunez, but it did little good. "Nunez told me it was no findings," she says. "I said, 'Well, what do you mean no findings?' "

It is not known if Wright was confronted about the allegations.  Nunez no longer works for NHC Bristol.   Lewis herself left NHC Bristol in 2005.   Aides were overstretched, she believed, and patients weren't getting the attention they deserved. She had begun to bring that anxiety home with her.  This theme recurs in interviews with former NHC Bristol employees.  Most aides say they can only effectively care for eight patients at a time. Bristol, Lewis says, would push that number to 12.

Lewis says the home circumvented rules by keeping a call log. If the facility was short-staffed, it would dial up an employee on the log. But if that employee couldn't come in, she says, the home had still satisfied state regulations just by making the call.

Nor were state-mandated inspections much of a threat. In an affidavit, Lewis claims NHC Bristol knew when state inspectors would arrive. Suddenly, employees were offered time-and-a-half and even double-time to ensure full staffing.

That did nothing to stem the complaints coming from Wright's charges. The next reported incident involving Wright occurred in 2004.  According to Emmons' memo, patient-care coordinator Amy Edwards was alerted to a suspicious bruise on a female resident: a perfectly round ring around her anus. Edwards in turn notified the new director of nursing, Ann Franklin. But she says Franklin merely examined the injury and shrugged. Edwards launched her own inquiry, interviewing aides who cared for the woman on various shifts. That led her to Wright.  He told her the resident was severely constipated, so he took care of it manually.

But Edwards remained suspicious. She later resigned in frustration, galled by the facility's chronic short-staffing and management's failure to investigate Wright.

It wasn't long before another aide—an NHC employee who requested to remain anonymous for fear of retaliation—walked in on Wright and a female patient.  In an interview with the Scene, the aide alleges that Wright had the curtain pulled closed, obscuring the view from outside the room. One arm was wrapped around the woman's shoulder; the other was between her legs.

"She had her hands on his and she was sweatin' and hollerin'," the aide says. "I said, 'What are you doing?' And he said, 'She won't turn loose of me.' She said, 'You devil, you. You won't turn loose of me. Get him outta here. Give him to the devil.' " When the nurse aide examined the woman, she claims she found a hole in the patient's diaper directly over her genitals, about the size of a 50-cent piece. "I knew something was going on," the aide says. "But it was my word against his."

The complaints, once sporadic, had become a chorus by 2007.  In April that year, Bristol police investigated claims that yet another female resident had been molested.  No arrests were made or charges filed.   At around the same time, Patty Davenport, then a new aide at NHC, says she saw Wright molest a patient during her first month on the job in April 2007.  According to an affidavit and a videotaped interview, she says she heard grunting coming from across the hall.  She had worked with this particular patient before, and knew that grunting generally signaled distress. When she entered the room, she says, she saw Wright fondling the woman's breasts.

"She was in her chair and he had her bra up, her shirt open and he was just like this," Davenport claims, working her hands over a pair of imaginary breasts. "Right in front of her, and she's in her chair, just shakin' and shakin', making all these sounds. I said 'Get your fucking hands off her. I'll finish dressing her.' "

Davenport reported what she saw to a nurse, who was disbelieving. "She said, 'Well, maybe you saw it wrong,' " alleges Davenport.  Since NHC has a strict chain of command, she's unsure if her report ever made it to top administrators. But she says Wright was effectively banned from caring for the woman.

"When the first time it happened, I thought, 'OK, maybe I did see it wrong,' " Davenport says. But a month later, she caught Wright in another compromising situation. Davenport walked into the room of a patient who was blind and could not speak. As she rounded the corner, she saw Wright sitting next to the woman on her bed. Her gown was up and Wright, she claims, was rubbing her genitals while stimulating himself. This time, she had no doubts. "Oh, hell no," she says. "Uh-uh. There wasn't no misunderstanding or none of that."  "I said, 'What the fuck are you doing?' " Davenport says.

She left the room and had an employee call director of nursing Franklin. Davenport says she told Franklin what she had seen and wrote her own statement. She told the head nurse that Wright's license needed to be revoked and his actions reported to the state. But Franklin insisted they follow the chain of command, she says. That would have led to NHC Bristol administrator Charlotte Wilson.  The next morning, Davenport called in sick. She was told that someone would cover for her: James Wright. She decided to quit on the spot.

"This has been going on for years," Davenport alleges. "[Other aides] said this. And I said, 'Well, ain't nobody said anything about this?' And they say, 'Well, it's not going to do anything.' There were over eight rooms he couldn't go in—couldn't take a tray. He couldn't do nothin'." Still, Wright retained his job—even though Davenport's claims wouldn't be the last brought to Franklin's attention.

According to a videotaped interview, Cynthia Aldridge was caring for a resident on a morning in July 2007. She asked the woman if she was ready for her morning bath. The patient said she'd prefer a shower, which struck Aldridge as strange.  The resident normally didn't like showers. Aldridge put on gloves to examine the woman's diaper. "And when I put the gloves on she went crazy and started crying and screaming, 'What're you gonna do? You gonna finger me like that boy did last night?' ".

She later spoke with the woman's daughter, curious to see if the mother was prone to talking like that. The daughter was stunned. Both reported the situation to the nearest nurse. The next day, Aldridge was asked to file a written report and submit it to the charge nurse. "I had went to [Ann Franklin] and told her, 'Look, if you need to talk to me about this, then I'm more than willing to talk about this,' " Aldridge claims. "[Franklin] just kind of blew it off."

Less than a week later, Aldridge says the resident's family pulled the woman from NHC Bristol. Not long after, a meeting was held during which the medical director pointed out that aides needed to show more respect to the nurses, Aldridge says. She could not hold her tongue.

"I said, 'How can you respect somebody that lets people get molested, lets people eat the patients' food?' " Aldridge says. She says several aides spoke up as well about Wright's alleged misdeeds—that they'd caught him eating patients' food (a firing offense) and with his hands beneath their blankets.

Sometime in August or September 2007, Wright resigned. The medical director did not respond to repeated interview requests, but aides say Franklin gave the accusation-plagued aide an ultimatum—leave or be fired.

Now the nursing home industry is moving to restrict lawsuits in situations such as this. State Sen. Jim Tracy of Murfreesboro, home to NHC, wants to restrict damages even in abuse cases to $300,000—if the home can prove it was "fully staffed" at the time of an incident.  The health-care lobby has given Tracy $23,000 in campaign contributions. According to the Center for Responsive Politics, NHC's political action committee spent $10,000 on Congressman Bart Gordon of Murfreesboro, and gave $84,000 in political contributions during 2008 to push its interests.  Please call these legislators and explain that they are protecting sexual predators.

The industry—and NHC in particular—are alleging lack of profits as their cause. In their PR campaign, nursing homes have argued that lawsuits are diverting money from patient care and employee wages.  This is untrue since insurance pays for defense costs and any jury verdict.

If the industry has fallen on hard times, though, it isn't showing.  NHC's ledgers look downright hearty.   It's one of the 15 largest nursing home chains in the country, with about 60 facilities in Tennessee and others spread from Arizona to Florida.  Since 2000, according to the corporation's own 10-k and the Tennessee Association for Justice, its net income has climbed to $43 million—a whopping 326-percent rise.

The company's part of an estimated $125 billion industry, with taxpayers picking up roughly 70 percent of that tab.  Homes have become so lucrative that independents have been gobbled up by investors and corporations. And that, says the Health Researchers and Educational Trust, has caused a corresponding decline in care. The ratcheting-up of profit margins, they argue, has often caused short-staffing. A separate AARP-funded study also found that for-profit nursing homes can generally be associated with lesser care.

This is not the first time Murfreesboro-based National HealthCare Corp. has raised questions about the quality of care in one of its facilities. Still smoldering in memory is the deadly 2003 fire that killed 16 residents at an NHC nursing home in Nashville. Widely reported at the time were the lack of a sprinkler system, the scarcity of smoke detectors, and allegations of insufficient staffing.

If you believe the current allegations, an NHC employee was able to prey sexually on patients over a seven-year period. Now lawmakers will decide if $300,000 is enough to compensate the people left in his hands.   Sen. Jim Tracy apparently thinks so. He is, after all, the bill's main sponsor and a beneficiary of nursing-home contributions. When asked about the incidents at NHC Bristol, he deflects the inquiries with noncommittal rhetoric.  "You know, you've done a question...those are some of the questions that are discussed when the bill moves through the general assembly," is all he'll say.

But that's understandable. He wouldn't be the first person in power who didn't want to look too closely behind those curtains.

 

 Co-workers say Charge Nurse Roberts remained Wright's steadiest defender, invariably taking his side as the allegations began to mount.   Roberts was a religious woman, and Wright's "professed" piety curried favor in her eyes.  "James played that card with her," Edwards claims. "He was wearing a wedding band, and when asked who it was, he said he was married to Jesus. I think that kinda blinded her eyes."

NHC pushing to protect profits and avoid accountability

The Tennessean reported on Murfreesboro-based National Healthcare Corp's CEO defending the ridiculous legislation to impose limitations on the amount of damages a victim of neglect, abuse, or negligence can be compensated for their injuries and pain and suffering.

Critics have labeled the bill the "Kill Old People Cheap Act."

"If we could lower our liability expense, we could put more into staffing," NHC President Steve Flatt said.  However, in all the states with caps on damages, the staffing remained the same!  These nursing homes have insurance and staffing is not affected by potential liability.  If they staffed properly to begin with then there would be less victims of neglect and negligence.  Flatt said his company saw a 20 percent loss in profits, going from $45 million in 2007 to $36 million in 2008. Opponents of the bill contend the nursing home industry spent between $700,000 to $850,000 to lobby for last year's version of the legislation.

 Daniel Clayton, a Nashville attorney and president of the Tennessee Association for Justice, says while the legislation falls short.   "There's not one word in their legislation that requires the nursing homes to improve the quality of care," he said. "We're (ranked) 47th in the country in quality of care of nursing homes by the federal government." "Quality of care comes first," said Clayton. "The legislation that they are proposing is to make good care optional. Good care should not be optional. It should be mandatory.

Opponents see the legislation as a way to enhance profits by the industry.

"This bill is all about the nursing-home industry trying to avoid full responsibility when it neglects or abuses a vulnerable resident. Caps don't improve care. If care improves, lawsuits go down."

NAACP Tennessee President Gloria Sweet-Love says the legislation comes at a time when state and federal reports have uncovered severe staffing and quality of care deficiencies. The CMS report uncovered that 49 percent of Tennessee Nursing Homes scored the poorest possible rating for staffing levels.

A report from the Government Accountability Office uncovered that Tennessee was one of nine states nationwide where health inspectors missed more that 25 percent of serious health and safety violations.  And a report recently released by AARP reconfirmed the poor state of Tennessee Nursing homes and found that tort restrictions have little impact on improving the quality of care in nursing homes.

The legislation would place arbitrary caps on non-economic and punitive damages in addition to making every negligent act that occurs in a nursing home protected under the Medical Malpractice Act.   "The nursing home industry's effort to conceal its true intentions is despicable and should be rejected by anyone who has ever had a loved one in a nursing home," Sweet-Love said.

"We need laws to protect our nursing home residents, not ones designed to protect the profits of greedy nursing home operators."

"If the nursing home industry would spend its money on more nursing staff, rather than on high-priced insiders, the quality of care in nursing homes would improve," Sweet-Love, the NAACP official, states in the news release. "The industry chooses to spend their resources on backroom conversations aimed at passing a law that immunizes the industry from negligent and abusive acts against helpless residents."


 

NHC's Press Release re: aquisition of more SC nursing homes

NHC Acquires Charleston, SC Facilities

National HealthCare Corporation (AMEX:NHC)(AMEX:NHC.PR.A), one of the nation’s leading operators of senior care services, announced today that it has added Trinity Mission Health and Rehabilitation of Charleston and Trinity Mission Assisted Living of Charleston in Charleston, South Carolina as affiliates effective August 1. NHC purchased the 132-bed skilled nursing and rehabilitation facility and the 60-bed assisted living facility for $13.25 million.

This acquisition increases NHC’s operations that are owned and managed in the South Carolina region to over 2,000 beds in 13 locations. The administrator for the new facilities, now renamed NHC HealthCare-Charleston and NHC Place-Charleston, is Angela Atkinson. Ms. Atkinson, previously with Trinity Mission of Charleston, joins NHC with 15 years of experience in healthcare administration, including licensure as both an assisted living and nursing home administrator.

“The superior quality of NHC’s services to the senior care community in the state of South Carolina is well known,” Steve Flatt NHC’s Senior Vice President of Development said. “While we have been a strong provider in the Upstate and Midland region for over 30 years, this additional location allows us to better serve the Low Country area as well. We are grateful for the help and cooperation of the staff of the center in making this a smooth transition.”

NHC has plans for more growth in the Low Country of South Carolina as construction is expected to start next month on a 120-bed skilled healthcare and rehabilitation center in Bluffton near Hilton Head Island.

NHC operates for itself and third parties 76 long-term health care centers with 9,772 beds. NHC also operates 32 homecare programs, seven independent living centers and 23 assisted living communities. NHC’s other services include managed care specialty medical units, Alzheimer’s units, hospice and a rehabilitation services company. Additional information about NHC, including the company’s Form 10-K, Form 10-Q, annual report and press releases, is available on our website at www.NHCcare.com.

Statements in this press release that are not historical facts are forward-looking statements. NHC cautions investors that any forward-looking statements made involve risks and uncertainties and are not guarantees of future performance. All forward-looking statements represent NHC’s best judgment as of the date of this release.


Contacts
National HealthCare Corporation
Gerald Coggin, Sr. V.P. Investor Relations, 615-890-2020

 

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