The state Department of Public Health has fined a dozen nursing homes in recent months for lapses in patient care, including the deaths of residents at homes in Bridgeport and Norwalk.
Bridgeport Manor in Bridgeport was fined $1,440 in December for failing to provide a resident with psychiatric services and adequate supervision, DPH records show. The resident was frequently observed playing with privacy curtains at the home. On Nov. 27, 2012, the resident was found with a privacy curtain wrapped around the neck and upper body and died two days later.
In an unrelated case last year, Bridgeport Manor was fined $650 when a resident with a traumatic brain injury struck the side of his or her head on a headboard, sustaining a cut.
In February, Paradigm Healthcare Center of Norwalk was fined $1,230 in connection with the case of a mentally ill resident who choked on food that had been left on a tray on Dec. 7, 2012. The resident had “copious amounts of food obstructing the airway,” sustained a brain injury and went into cardiac arrest, records show. The resident died a week later when life support was discontinued, DPH records show.
Jonathan Neagle, a court-appointed receiver, said the home was under state receivership when the incident happened. “This accident clearly was an accident, and all the policies and procedures in place have been reinforced to prevent any further incidents,’’ he said.
Bridgeport Manor officials could not be reached for comment.
The other citations, according to DPH records, were:
• Lord Chamberlain Manor Nursing & Rehabilitation in Stratford was cited twice and fined a total of $1,510 on Dec. 4, 2012 for lapses in care. One resident was missing for two and half hours in the home before being found alone “trembling and crying.” One resident broke a leg in May 2012 after sliding out of a wheelchair and investigators concluded the home failed to prevent the injury. In November 2012, another resident slid off a shower chair and broke an ankle.
• Masonicare Health Care Center of Wallingford was fined $1,420 in January for neglect of a resident with Parkinson’s disease. A nurse’s aide did not clean up the incontinent resident and made a vulgar comment about the resident to another aide, records show. The aide was fired.
• Manchester Manor Health Care Center in Manchester was fined $1,280 in January when investigators learned that a nurse’s aide had slapped a resident on the hip in July 2011. The aide denied hitting the person but admitted to being “rough during care and shouting at the resident,” who was not injured, records show.
• The Summit at Plantsville was fined $1,160 in February for not properly monitoring a resident who had a wrist splint. According to an inspection on Jan. 25, the resident developed a pressure ulcer and needed antibiotics and the facility failed to follow its own care procedures.
• Paradigm Healthcare Center of Waterbury was fined $1,160 in January in connection with an incident in which a resident with dementia was cut on the forehead during a fall. The state concluded the facility did not have measures in place to safely transfer the resident to a toilet.
• Pines of Bristol Center for Nursing was fined $1,160 in January in connection with a 2012 incident in which a resident with Alzheimer’s fell and broke a hip. State investigators determined that an assessment of the resident’s likelihood to fall was not completed when she was admitted on Oct. 5 but was filed on Oct. 23, the day she fell.
• Fox Hill Center in Rockville was fined $1,160 in December for an April 2012 incident in which a resident with Alzheimer’s broke a wrist after falling when left alone in a bathroom. Investigators concluded the resident should not have been left unattended.
• Apple Rehab Guilford was fined $1,090 in January in connection with 2012 incidents in which two residents broke hips. One resident fell after being left alone in a bathroom despite being considered a high risk to fall.
• Bayview Health Care in Waterford was fined $1,020 in January for a November 2012 incident in which a nurse’s aide shoved a washcloth in the mouth of a resident with dementia and pinched the resident’s nose three times. That aide was fired, along with another aide who witnessed the incident but did not intervene out of fear of retaliation from the first aide.
• Salmon Brook Center in Glastonbury was fined $360 in January in connection with an April 2012 incident in which a nurse’s aide was verbally abusive to a resident with dementia and did not clean up the incontinent resident.
The recurrence of these incidents reflect a neglect of the system of care, its workers, the elders, and disabled people being cared for… The steps that the state has taken through the Department of Health and the sanctions applied are routinely inadequate. Just ten years ago Connecticut was ranked as 33rd in the nation for Nursing Home Staffing based on Medicare data – and its staffing requirements have not been updated in 30 years. The Federal Health and Human Services Department recommends a minimum level of 4.1 hrs of combined staffing hrs. for adequate Nursing home care, while Connecticut law only requires 1.9 hrs per day. Last year Connecticut, was ranked among the top 6 states (also based on Medicare data) for the unneeded and dangerous use of anti-psychotic drugs on Nursing Home residents. It doesn’t stop there. Connecticut’s hospitals this past year were in the top 2 states for Medicare fines for re-admissions within 30 days. What this means is that elders who are already ill are experiencing unnecessary pain and new conditions due to errors or neglect in care. The Commonwealth Foundation foundation also did a study that showed Home Health Services in Connecticut fell into bottom third of the nation for key indicators. There is no other way to interpret these statistics except as a failure across the entire continuum of care for services for the elderly and disabled. In some cases the way these institutions are allowed to be administered amounts to state-sanctioned- neglect. (Dr. Ira Byock, the nationally known authority on Palliative Medicine has called our national system of Nursing Home Care a disgrace, http://bigthink.com/videos/do-we-mistreat-the-elderly) Connecticut should be at the forefront of progressive action in giving our elders the care that they deserve.
It is any surprise with such ratings that the state operates an oversight system where 4 nursing home residents die can die within the last year from preventable choking, with the 1st 3 facilities garnering fines on average of less than $600? Or that the admirable State Ombudsman program must function with 9 nursing home advocates for the whole state with over 200 facilities and a population of 30,000? How is that elders under care in highly rated facilities can develop vitamin deficiencies, or that one such facility could be cited for 3 out of 4 years for the lack of an infection control program and this remain at a minor level? In the same 4 star rated facility one resident didn’t receive dental care for 2 years. Facilities in the state with high usage of antipsychotic drugs are not sanctioned , nor are there quality ratings effected on the Medicare Nursing Home Compare site.
As the legislature considers the Long Term Care Rebalancing Plans offered by its planning committee and the Governor, these concerns should not be forgotten. The language in these plans is laudable calling for person-centered care,” “meaningful rights and protections,” and “consumer input at every level,” and aims to keep more people in the community out of nursing homes in a variety of settings, but makes no assessment of rights, protections, and advocacy in the current system, or how they will work for a greatly expanded population. It provides no blueprint for what it defines as its “governing principles” to be realized. It also does not address prevention which is known to to save dollars. While there was no significant outreach for input to current residents of nursing homes and their families in the planning, what the plan does do is discuss the number of beds that will be needed, the growth of the population, and the savings to be achieved by deinstitutionalized care. Connecticut deserves to be at the forefront of innovative and fiscally responsible Long Term Care reform, but without a truly “person-centered” system of care, it risks perpetuating current failures and creating more suffering.
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