A Waterbury home health care agency has been fined $5,000 and ordered to hire a nurse to monitor patient safety for at least three months due to multiple violations found during unannounced inspections.
Dorothy Boyles, owner of Hamlett Health Services of Waterbury, agreed to the fine and monitoring when she signed a consent order with the state Department of Public Health on June 16.
In a Jan. 6 letter to Boyles, DPH outlined numerous violations it found in patient care, including a failure to properly follow doctor’s orders and to properly administer medication, during visits Nov. 14, 18, 19, 20 and Dec. 11. Some of the cases involved powerful narcotics such as morphine and Oxycodone.
Laurie Lofgren, who returned a call seeking comment from Boyles, said she purchased Hamlett on June 17. She said the home had a nurse consultant that monitored conditions in the agency from January to March and that she is bringing the same consultant back. She said she had no reservations about buying Hamlett and changes made at the agency were “cleared” by DPH.
“It’s essentially a new agency, a new staff, a whole new culture,’’ she said. “Patient care is my number-one priority.”
While accompanying nurses and aides on home visits, DPH inspectors cited the agency for several cases of improper administration of medication. Registered nurses were observed taking unidentified pills out of envelopes during home visits and failing to verify each medication before giving it to patients, the violation letter states.
On Nov. 18, a registered nurse left one patient’s evening dose of morphine sulfate with the patient without checking how many pills were taken the day before. The agency’s employees should have brought medications in pharmacy-labeled containers and signed off on medications at the time they were given, the letter states.
In another case, a nurse left Oxycodone during a visit Nov. 18 and did not administer it but had signed off ahead of time that he or she had administered it, the letter states.
For another patient, visiting nurses signed off as having given doses of morphine sulfate and Hydromorphone, another painkiller, twice on a day the patient was not home, but was in the hospital, the letter states. Hamlett nurses would routinely obtain several days of medication at a time, and some nurses brought back the medication when the person was in the hospital but others carried medication in their cars until the person was back home, the letter states.
With one patient, nurses failed to document the person’s blood pressure on 13 visits and failed to document the patient’s heart rate on 25 visits but didn’t tell a doctor that the checks weren’t done, the letter states.
On seven visits to one patient, elevated blood pressure was noted, but records failed to show that a doctor was notified, DPH’s letter states. One patient had elevated blood glucose levels for five days in November but records failed to show whether nurses had informed the patient’s doctor, DPH found.
One patient was hospitalized with an opiate overdose but was discharged June 26, 2014. The home failed to document whether the person had been assessed by nurses on June 23, 23 and 24, even though the evening medications were signed off as having been administered by a nurse those nights, the letter said.
EMTs taking one Hamlett patient to the hospital reported that the person’s apartment and body were “unkept,” the person’s feet were caked with dried stool and the patient had an open wound on the abdomen, DPH’s letter states. Hamlett’s records failed to show whether the agency’s registered nurse had assessed the patient’s skin condition or hygiene and failed to indicate whether a referral had been made to a social worker to address the condition of the apartment, DPH’s letter states.
The agency also failed to keep accurate records for seven patients, DPH found. For example, on June 27, 2014, EMTs found a patient unresponsive outside of his or her apartment, but the agency’s records said an aide had provided services to the patient at the same time that person was being taken to the hospital by ambulance, DPH’s letter states.