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wptv.com

Contact 5 Investigates local nursing homes

Reported by: Shannon Cake
Email: scake@wptv.com
November 17, 2009

If you have a complaint about a nursing home or assisted living facility, or would like information about the annual assessments of the facilities, you can contact Florida’s Long-Term Care Ombudsman Program. The telephone number is: 1-888-831-0404 (toll-free), or Click Here

WEST PALM BEACH, FL -- West Palm Beach native Ronnie Johnson was desperate to find a nursing home that her mother could call home.

“My mother was everything to me,” said Ronnie Johnson. “She did everything for me while she was alive. She was this beautiful woman who sung with the national symphony orchestra.  She carried an entire team of students to represent the United States in the WorldExpo.  She did unending fantastic things."

Patricia Johnson was indeed a trail blazer. At 16 years old, she went off to Howard University in Washington D.C. She stayed 7 years, earning two masters degrees from the prestigious university.

Patricia Johnson’s star burned so brightly, she graced the cover of Jet Magazine in the 1950’s. The fourth generation Floridian had an amazing voice and ran in circles with the likes of Roberta Flack, Jessye Norman and other famed musicians. She brought all that talent back to South Florida and taught music at local colleges and prep schools for many years.

In 2008, at 75 years old, the retired professor of music was admitted to a local hospital to have her foot amputated. There were no problems with the procedure, according to her daughter, but during a nursing home rehab stint, Ronnie claims her mom developed a terrible bedsore.

"I mean it was huge,” Ronnie said. "It had eaten away most of her hind part, and basically she could not any longer sit up at any time."

Doctors gave Patricia a colostomy bag to keep her feces from further infecting her wound. Ronnie says she moved her mom to Darcy Hall of Life in West Palm Beach, a place she thought could handle that kind of care.  Ronnie says she stopped by to visit the day after moving her mom into the facility.

"As I was walking down the hallway, I started smelling this horrible smell,” Ronnie remembers.  “I walked up to her door, and it was closed, so I assumed they were changing her. I walked in, and she was crying. The smell was coming from her room!  There was black stuff all over the wall.  It was my mother's colostomy bag.  It had exploded because they never changed it. The colostomy bag exploded on the wall and it was dripping down the wall.  My mother was crying.  She said to me,  ‘I just want to die!’  I couldn't believe it."

Ronnie said she called for the nursing staff who assured her the mess would be cleaned up and it would never happen again.

"I came back the next day,” Ronnie said, “and the same thing again.  The same thing happened again!"

"That's bad.  That's real bad, particularly since it was a recurrent situation,” said Irwin Lamm, an Associate Professor in the Healthcare Administration Division at Florida Atlantic University. “There is no excuse for that, that is poor nursing care.”

Lamm has spent his life running nursing homes and helping the state of New York turn around problem facilities.

He's a backer of The Center for Medicare and Medicaid's 5-star system. Inspectors use it to grade nursing homes when they visit. 

“The second these people (inspectors) walk in, the facility is theirs. They check medications. How are they being distributed? Are narcotics locked up? It’s everything operational from top to bottom."
Contact 5 and the Scripps Howard News Service studied 3 years worth of inspection reports for every nursing home in our viewing area.  A score of 5 is the highest, one is the lowest.  Darcy Hall of Life Care received an overall grade of 3.

We contacted administrators at the Darcy Hall of Life about Patricia Johnson’s case. 
In a statement, Executive Director Kris Bernsten said:

   “Residents are our first priority at Darcy Hall of Life Care, and their safety and well-being is our paramount goal in our day-to-day operations. We have a dedicated corps of associates who are committed to that mission of service. 

   Our of respect of the protected health information of the resident in question, Darcy Hall of Life Care will not discuss any aspect of her stay at our facility.  However, we can assure you that she was treated with the utmost dignity and cared for as a member of the Darcy Hall family.

  The most credible source of information about Darcy Hall of Life Care is to have your own first-hand experience. Our community can come see for themselves the love and compassion between our family of residents and associates—we welcome that anytime.”

While Darcy Hall of Life Care in West Palm Beach, received an average rating in its most recent inspection report, the Scripps Howard News Service found several local homes scoring way below the national average.

ManorCare Health Services in Boca Raton is one of them. The facility received an overall grade of 1 in its recent inspection report.

The Contact 5 Investigators requested a tour inside the facility. Julie Beckert, the Director of Marketing Communications for HCR ManorCare, which is the parent company of ManorCare Health Services in Boca Raton, denied our request.

"We have to protect the privacy of our residents," Beckert said.

She did send the Contact Five Investigators this formal statement:

    "We support providing accurate information to the public about the care provided in skilled nursing centers; however, CMS’ Five Star Quality Rating System fails to differentiate between the levels of care and services provided by the 17,000 plus skilled nursing centers in the United States.

    The system does not recognize that providers such as ManorCare that provide a very high level of comprehensive medical and intensive rehabilitation should be rated on different criteria than centers who provide a less complex level of care or who operate more as residential caretakers.

      The five star rating does not measure the programs and services that go above and beyond basic care. This system does not reflect innovation in facilities such as how well pressure ulcers are healed, whether centers provide pressure ulcer prevention services or how well a center works to reduce pain. The system also does not take into account the professional staffing levels of therapists and nurse practitioners and consultants that may be on board in higher acuity centers. There is no measure for what rehabilitation programs and services are offered to patients which is the reason the majority of our patients come to ManorCare.

    We strongly urge all patients and families to use this rating system as only one tool when considering a skilled nursing center. Visiting the center, reviewing patient and family satisfaction surveys, asking about the expertise of the center to handle high-acuity patients or the specific disease or injury, talking to families and patients about their stay, and requesting information on a center’s results in meeting patient and family goals should be an integral part of any admission decision."

Contact Five's research backed up some of the theories mentioned by HCA ManorCare.  We found a 2006 General Accounting Office study that shows state inspections often miss serious violations in nursing homes and overlook problems like neglect and bedsores.

According to Lamm, you can identify those problems if you know what to look for.  For instance, Lamms says, contrary to popular belief, nursing homes should have no distinct odor.

"A nursing home should not smell.  There is no reason for a nursing home to smell, unless there has just been an accident,” Lamm said.  “But then it should always be cleaned up within 15 or 20 minutes.”

Lamm agrees, the government’s 5 star system can be improved, but overall, he believes in what the system delivers to consumers.

"I think the 5 star system is reasonable. It’s a starting point for the laymen, but there's nothing that replaces your own feelings as you walk through the place.  Is it dingy?  Is there life to it?  Does there seem to be interaction between the staff and the residents?” Lamm said.

It's the reason Lamm and other nursing home insiders encourage several thorough on-site visits before choosing a facility.

"You go in with the nose, with your ears, with your eyes and you look and you smell and you touch,” Lamm said. “You'll get a feeling when you walk into that dining room, if you find 15 people with their heads down on a dining room table, and the nurses talking to each other instead of tending to the residents, you’ve got  a lemon of a facility."

Ronnie Johnson says her mother's dark final days were a sharp contrast to the life the talented musician lived on stage.

"I'll never forget it,” Johnson said of her nursing home experience.  "They don't know where you've come from, who you are, it was a horrible situation.  It's been over a year and I remember what I saw like it was yesterday, because it so was traumatic."

According to Ronnie, Patricia Johnson died almost three weeks after the colostomy bag incident in the nursing home.

"To see her lose her dignity, because that’s what it was.  She lost her dignity,” Ronnie remembers. "It was so hard for me to take. I have cried buckets over it.  My heart is broken.  My heart is just broken."

Choosing a nursing home or along-term care facility for yourself or your loved one will be one of the toughest decisions you make in your lifetime. With so much at stake, experts have some tips to help you get it right.  Click here for the AARP’s recommended tips on selecting a nursing home