A Litchfield residential care home has been ordered to hire a new manager, improve resident care and pay a $2,000 fine, after findings that administrators left residents hungry, denied them information about their personal finances, and openly referred to them as “monkeys.”
Multiple residents of Fernwood Rest Home, Inc., a 68-bed facility, told inspectors from the state Department of Public Health (DPH) that administrators would tell them they had to “go shopping to feed the monkeys,” a state DPH report says. A staff member of the home confirmed complaints from residents that administrators would put a chain across the dining room while the staff was making a “gourmet breakfast for themselves,” and would instruct staff members to “keep the monkeys out” of the room while they were eating. At the same time, the facility, with a significant population of mentally ill residents, skimped on meals for residents, offering them eggs for breakfast only two days a week, with hot and cold cereal provided on other weekdays and donuts on Sundays, the report says. Residents told inspectors that the only snacks provided were granola bars, “with some residents indicating that they are still hungry and are told they cannot have any other snacks until the next day.”
The home was cited for eight violations, including failing to treat residents with dignity and respect; failing to give them quarterly statements or receipts pertaining to their personal financial accounts; and failing to provide “routine recreational activities” for them. In addition, no resident council was in place to allow residents to discuss their living conditions or push for improvements, the report says.
A pilot project to provide coordinated care to children insured by Medicaid resulted in more Connecticut children receiving preventive dental services, mental health care and well-child visits, according to a new report by the Child Health and Development Institute of Connecticut, Inc.
“Care coordination is especially important for children, as they benefit most when their needs are detected early and they receive intervention services,” the report says. “The primary care medical home is an ideal venue for detecting children’s problems at the earliest possible age and connecting families to helpful interventions and supports outside of the primary care site.”
The evaluation of the “Health Outreach for Medical Equality” project, dubbed “H.O.M.E.,” found that adding care coordinators to work with low-income children in the HUSKY insurance program boosted the percentage of Hartford children ages 2 and younger using dental services – 34 percent for those who received care coordination, vs. 25 percent of Hartford children overall. In addition, children who received H.O.M.E. services accessed behavioral and mental health services at a significantly higher rate than the overall Hartford HUSKY population. The increased access to dental and mental health care “pays off tremendously in the long run,” in terms of both health outcomes and cost savings, as problems are addressed earlier, said Lisa Honigfeld, vice president for health initiatives at the Child Health and Development Institute.
As a practitioner at Yale-New Haven Hospital, Dr. Leora Horwitz has seen her share of patients who misunderstand medication changes made during their hospital stays. Just recently, one of her female patients, who was switched to a new beta blocker for high blood pressure during an inpatient stay, landed back in the hospital after discharge because she had taken both the new medication and her old beta blocker – a combination that lowered her heart rate and blood pressure to dangerous levels. “Every physician can tell you about these kinds of errors,” Horwitz said. “We do a relatively poor job of educating patients about their medications.”
As a researcher, Horwitz can now quantify those lapses. A recent study she led looked at 377 patients at Yale-New Haven Hospital, ages 64 and older, who had been admitted with heart failure, acute coronary syndrome or pneumonia, then discharged to home. Of that group, 307 patients – or 81 percent — either experienced a provider error in their discharge medications or had no understanding of at least one intended medication change.