Five nursing homes were fined by the state Department of Public Health for lapses in care.
A $1,020 fine was levied on the Golden Hill Health Care Center of Milford for failing to provide proper care to a resident who needed splints/braces on his or her lower extremities. An inspection in January found that there was no record that the resident’s skin was monitored, as directed in the care plan. The resident suffered skin wounds caused by pressure from the incorrect use of the splints/braces, according to a DPH inspection report.
The Bishop Wicke Health & Rehabilitation Center, Inc., of Shelton was fined $1,090 for failing to properly supervise a resident who fell twice in August 2012. The patient sustained a hip fracture, as well as lacerations of the forehead and arm, after being found on the bathroom floor. Also, the nursing home was cited for loose bedrails during an inspection.
The Pope John Paul II Care and Rehabilitation Center of Danbury was fined $1,090 after a resident developed a pressure ulcer on the thumb, as a result of the use of a hand splint. The resident, who also was identified as at risk for falls, sustained injuries from falling when he or she was not properly assisted or supervised.
The Portland Care & Rehabilitation Center of Portland was fined $570 after an incident in which a certified nurse’s aide admitted taking a Fentanyl narcotic pain patch from a patient. The aide was placed on administrative leave, according to the DPH report.
The Chesterfields Health Care Center of Chester was fined $1,420 for failing to properly supervise a resident who was identified as a danger to himself or herself and others. The resident, with a history of bipolar disorder, dementia and depression, had resisted care and become abusive to facility staff, but was not properly assessed for those concerns, the DPH report says. The patient was transported to an acute care hospital by taxi – instead of being properly transported by emergency medical personnel.
What to make of these reports? If I were a casual reader, I might just assume that nursing homes are bad places, which as the common wisdom holds, everyone wants to avoid. If I were a relative of someone who had to have long term care, I might judge these facilities as the bad apples. But on Nursing Home Compare, Medicare’s website that rates facilities for the public, all of these homes have average to high ratings, and several of them have four or five star accolades. One of the homes has a rating from Consumer Reports as one of the best Nursing Homes of 2013.
So what does this mean? Some of the citations reference the lack of supervision. More troubling are the ones which relate to the development of conditions which can only occur with neglect over time like skin problems. Unfortunately where long term care is concerned it can be difficult to see the forest for the trees. Could it be that this reflects that Connecticut has among the lowest nursing home staffing requirements in the nation?
In 2009, then Attorney General Richard Blumenthal joined his counterparts from 30 other states petitioning the Health and Human Services Director, to revise the Nursing Home Compare Rating System to make a true national standard. For while this is what it appears to be, it is actually an intra-state rating system – where all nursing homes within a single state are placed on a curve so there is always a top and a bottom. If North Korea were the 51st state, in this system, it too could have four and five star nursing homes.
As such it appears like a spin of the roulette wheel, where almost any adverse event can occur in any facility. Sometimes they are cited and sometimes not. There is also an informal resolution dispute process available to facility managers which can take infractions completely off the books. In contrast, in 2012 the state legislature unanimously established a minimum fine of $5000 for repeat cases of animal neglect and abuse. Some of the deaths in Connecticut Nursing Homes due to care lapses last year merited fines of less than a thousand dollars. In this session, a committee of the legislature is considering a bill with broad public and representative support which would assure that animals have court appointed representatives in cases of abuse and neglect. For nursing home residents and their families who make complaints to regulators about care there is no hearing. Hello! The last time I looked around none of us are getting younger. Perhaps if our dogs and cats could advocate for us they would, but it appears we will be on our own. Maybe our kids will do a better job than we are doing for our elders.