Under The Whitewash: Is Your Loved One Safe In A Nursing Home?

You would think that someone who reads about elder abuse and neglect on a daily basis would stop seeing red after a while.  Yesterday, however, while reading an account of nursing home neglect that resulted in a death, I was struck by a statement from an Illinois official responsible for regulating nursing homes that was so out of touch with reality that my fingers shook as I hit the keys on my laptop to respond.

An investigative piece by NBC Chicago5 tells the sad story of Joseph Karney, a Chicago man who moved into The Renaissance Park South nursing home in 2005 after having a stroke and heart attack. Joseph was later diagnosed with gastrointestinal cancer and placed on a medication to which he was responding well. Over time, his sister noticed he was failing. They investigated and learned that the nursing home had failed to give him his cancer drug for almost a year and hadn’t taken him for follow-up appointments with his oncologist. It was too late. Joseph’s cancer had spread and he died. The investigative report included an analysis of Illinois Department of Public Health data where state health inspectors documented 384 nursing home medication errors since 2011. These errors resulted in two deaths and an amputation. Full story here.  http://www.nbcchicago.com/investigations/Nursing-Home-Medication-Errors-Leading-to-Hospitalizations-243618471.html

Here’s what Dr. LaMar Hasbrouck, the head of Illinois Department of Public Health (Illinois’ nursing home regulatory and oversight agency) said about these errors:

“You’re going to have errors, unfortunately. But we hope that there are no errors due to negligence,” said IDPH director LaMar Hasbrouck, MD.

So this is where my blood begins to simmer. Are you kidding me, Dr. Hasbrouck?  Where have you been? You do know that Illinois nursing homes, based on inspection data, have an F grade on Nursing Home Report Cards, right?  http://nursinghomereportcards.com/

Do you know that Illinois ranks dead last in direct care staffing hours? Those are the people who pass medications and provide care to residents in your nursing homes.

Still simmering, I read on because, of course, we’ve still got to hear from the well-paid talking head from IHCA (Illinois Health Care Association, a state trade organization for nursing home corporations). Mr. Vrba, whose main job is to put lipstick on pigs, tosses in this red herring about medication errors in an effort to make the public think, “Oh yeah. I mean, that could happen to anybody.”

Facility staff members are also using TALL MAN letters, Vrba said, to differentiate look-alike drug names. For example, noting predniSONE as opposed to prednisoLONE.

TALL MAN letters! A man went without his cancer medication for a year and Mr. Vrba wants us to believe that it’s because the staff wasn’t using their latest best practice named TALL MAN letters.

So what kind of letters should have been used so that the nursing home staff would have noticed that Joseph didn’t get his cancer medication–FOR A YEAR? Are there special letters or numbers that would have ensured he was taken in for his follow-up oncology appointments?

Perhaps the problem lies a bit below the surface here, at a depth that the likes of Mr. Vrba never want us to reach. Let’s take a look at Medicare’s Nursing Home Compare Website and see what’s up with Renaissance Park South. http://www.medicare.gov/nursinghomecompare/profile.html#profTab=0&ID=145764&loc=CHICAGO%2C%20IL&lat=41.8781136&lng=-87.6297982&name=RENAISSANCE%20PARK%20SOUTH

We learn they’re a for-profit nursing home owned by several players who run other substandard nursing homes in Illinois. They have a 1 star rating for both Staffing and Health Inspections. A one star rating by CMS (Center for Medicare Services) on this site means Much Below Average.  It’s as low as they go.  There have been a total of 6 complaint inspections in 2013 alone with repeated deficiencies related to poor staff training, abuse and neglect, and lack of therapeutic programs for residents with mental illness.

One of Renaissance’s owners, David Hartman, also owns Symphony of Crestwood, Illinois. Sadly, the name is the only nice thing about this nursing home. Data from Nursing Home Compare show us that Symphony is plagued with many of the same problems as Renaissance.  Poor staffing, neglect, use of chemical restraints (over-drugging residents to keep them quiet), failure to provide activity programs, failure to report theft, and failure to prevent pressure ulcers to name a few. The most egregious finding was in a complaint inspection report from last July, 2013:

Based on interview and record review facility failed to ensure necessary treatment to promote healing and prevent infection of a wound for one (R1) of three residents reviewed for pressure ulcers. Failure to provide dressing changes as ordered, resulted in R1’s right foot harboring purulent drainage with maggots on the wound.

Maggots in a wound in what is supposed to be a health care facility! This lack of care goes beyond any dribble about nursing error. This is absolute and blatant negligence that begs for public outrage over this less than Third World level of care.

I must admit though, of all the inspection reports and comments I read yesterday, this statement by Dr. Hasbrouck,  blew my blood pressure beyond the pale. Keep in mind, Dr. Hasbrouck is director of nursing home oversight in Illinois so common sense would suggest that he is on the side of protecting nursing home residents.

“Safety and quality of care is a collective responsibility,” Hasbrouck said. “The family has a responsibility to do their due diligence.”

Family responsibility?  Is he suggesting that Joseph’s family is to blame for putting him in this substandard nursing home that receives his agency’s stamp of approval to remain open? Guess who the usual suspects are when it comes to calling in nursing home complaints.  Families!

Do you know how many families across Illinois, across our country, need to make sure someone checks on their loved one each day just to make sure they’re fed and not soaking in their waste?

What about all those people who don’t have families or are estranged from their families?  Everyone deserves decent and humane care.  No exceptions!   And substandard care is never the fault of grieving family members who are floundering through our system, begging for someone to care about what is happening in nursing homes.

What about your responsibility, Dr. Hasbrouck? I believe part of your job description as director of Illinois’ Department of Public Health would be to enforce nursing home regulations that have been put in place to protect our most vulnerable citizens?

How do you suggest citizens do their due diligence?   How can we protect our vulnerable brothers and sisters from the kind of human neglect that results in maggots infesting their wounds?  Help us understand how is it that public money continues to flow into the hands of nursing home owners who accept that money as their entitlement while their nursing homes flounder?

Channel 5’s news piece provides us all with a perfect example of the deplorable care given in many of our nursing homes.  The players in this story show us why it won’t change anytime soon.

Even when someone does speak out, as Joseph’s sister did, and even when their voice is heard by many, change doesn’t result.  Instead, the guilty deflect the blame. Wealthy nursing home corporations blame reimbursement, government officials deny the seriousness of the problem and, in this case, lay the blame at the feet of families who choose homes that provide poor care.   The nursing home industry invents some shiny new “campaign for excellence” developed for the sole purpose of lulling the public back to sleep with visions of things like TALL MAN letters.

And while we sleep, nursing home corporate owners get richer, their ‘perception managers’ get slicker, and government oversight becomes more and more impotent.

Citizens of Illinois, I suggest you follow the advice of Dr. Hasbrouck and do your due diligence.  Do it by banding together and demanding reform and transformation of this mess we’re all paying for called nursing home care.