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Violence, shackled prisoners, questionable care revealed at nursing homes

Filed by KOSU News in Feature.
February 6, 2013

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It’s almost always a tough decision to put a parent in a nursing home. You might feel like you’re outsourcing their care, and could get skittish about handing them over to strangers. The vast majority of nursing homes in Oklahoma do a more than satisfactory job. But a KOSU investigation finds a handful have been repeatedly cited by inspectors for life threatening conditions…

Buena Vista Care and Rehabilitation Center in Midwest City is licensed for 187 beds. Up until a couple months ago, Sun Healthcare ran the facility. Then, in December, the nursing home giant Genesis Healthcare took over. But it may not be running much longer. Their long list of problems found by inspectors once included gang affiliated inmates as patients.

“Well the problems at Buena Vista had been around. It took a lot of us by surprise, however, that they had been foolish enough to admit shackled prisoners. That was an administrative decision that was inexplicable to me.”

Ester Houser is the long term care ombudsmen for the state. She can independently investigate complaints from residents, or send one of her field workers scattered across the state into a home.

The problems at Buena Vista have been extensive. The most prominent one, as Ester mentioned, came in 2011. Four inmates, one convicted of murder, from a private prison located in Oklahoma, took up residence in the facility. According to federal inspection reports, those inmates –once involved in a violent prison riot- were shackled to the beds, with guards standing watch.

“I don’t know in this case whether or not the administrator lost his or her license, but that would be one way to reward such incredibly poor judgment. To block that administrator from ever managing a nursing home again.”

But the problems have continued. Other inspection reports show they didn’t have enough nurses to give out pain medication, failed to tell family members of falls, and even a violent incident where a nurse pulled a patient out of bed against her will.

“It is unfortunately, usually a demonstration of a breakdown of the system in the facility, beucase it means the facility was unable to achieve compliance and they were unable to correct their deficiencies. So it will speak to a number of system issues, usually going all the way up to the top levels of management.”

Dorya Huser is chief of long term care for the state of Oklahoma, and also supervises the facilities. For the last 16 months, Buena Vista has been listed as a Special Focus Facility by federal inspectors, and data compiled by the nonprofit journalism outlet ProPublica finds it ranked 16th for the most serious deficiencies of any home in the country in the past three years.

Sun Healthcare also handed off homes in Henryetta, Broken Arrow, Seminole, and Oklahoma City to Genesis. But one didn’t make it into their hands: Woodland View Care and Rehabilitation Center in Tulsa. That’s because Medicare and Medicaid stopped reimbursing the home for treatment, and last year, they agreed to a license suspension.

“It is a difficult business to take care of these residents. These are people that are frail, elderly, compromised medically or mentally. And so it can require a lot of approaches in order to care for these people appropriately. But that’s what these facilities are for.”

Over the past three years, federal authorities have brought more than 350-thousand dollars in fines, a number nearly double the next closest facility. A federal inspection from 2010 reported residents in immediate jeopardy. One resident was incessantly scratching at her chest, with no one further investigating the issue. Others didn’t get proper treatment as ordered by physicians.

“It can just be a demonstration of system failure. A lot of poor outcomes can come from just an ineffective system that is put in place.”

And the problems, although not nearly as widespread at other facilities, repeated across what are now Genesis’s homes. Since 2010, fines totaling 29-thousand dollars at Seminole Care and Rehabilitation, with too few nurses. Nearly 17 thousand at South Park Care in Oklahoma City, where staff failed to notify family of an incident.

KOSU reached out to Genesis multiple times. They declined to participate in a taped interview for this story, but did issue a statement acknowledging problems in the past, specifically at Buena Vista. They say all the issues have been resolved and are awaiting another inspection.

Craig Davis, with AARP Oklahoma, says some prevention could come from the Legislature.

“Any abuse is too much abuse, and there’s always more work that can be done to protect the frail and vulnerable seniors in Oklahoma.”

But he says an unannounced visit at a nursing home before moving a parent in can be critical. Ester, the state ombudsmen, says it’s a team effort…

“It requires more than just inspectors and more than just ombudsmen. The visits of people who love the residents is also part of that equation and cannot be underestimated in the potential impact it has on protecting residents’ well-being.”

In the last three years, six nursing homes have been closed by the state. But none ever were owned by the same group.

That could change in March. If Buena Vista does not reach substantial compliance with federal regulations, it may lose all Medicare and Medicaid reimbursement, joining Woodland View. After that, it can be difficult to ever get it back.

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