Deaths, injuries linked to nursing home care in state

1 in 10 Ohio facilities faulted for substandard care in past 4 years.

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By Ben Sutherly and Hannah Poturalski, Staff Writers 10:49 AM Monday, September 12, 2011

BUTLER COUNTY — One in 10 nursing homes in Ohio has been faulted in the past four years for substandard care, or for practices that put residents at immediate risk of injury or death, according to a Hamilton JournalNews review of state data.

Across the state, between August 2007 and May 2011, at least 22 nursing home residents died and at least 42 others were injured in 114 incidents, the newspaper’s investigation found. Those 114 incidents resulted in “immediate jeopardy” or “substandard care” findings by state officials.

Fourteen of those incidents — resulting in four deaths and one injury — were at nursing homes in Butler, Montgomery, Greene, and Clark counties.

“There are instances where very good homes could have immediate jeopardy, and they’ll fix it immediately,” said Bob Applebaum, director of the Ohio Long-term Care Research Project at Miami University’s Scripps Gerontology Center. “It’s just the bad luck of the draw.”

An “immediate jeopardy” finding is the most serious violation nursing homes can receive from the state Department of Health, which conducts annual nursing home surveys and inspections.

Reimbursement cuts for nursing homes contained in the new state budget raise questions about whether nursing home safety could become a bigger issue.

The Ohio Health Care Association, which ran television advertisements critical of the Medicaid rate cuts, estimated the Medicaid overhaul will cost the nursing home industry 5,600 jobs.

“The one thing that we do seem to know about quality is that staffing matters,” Applebaum said.

In Hamilton, Mercy Franciscan at Schroder anticipates a cut of about $300,000 by the end of 2012, according to Pete Gemmer, spokesman for Mercy Health Partners.

“These state and federal measures will require us to become even more efficient in the delivery of care,” Gemmer said.

In January 2010, the Hamilton nursing home experienced an immediate jeopardy case after two licensed practical nurses failed to administer CPR to a resident found unresponsive and not breathing, according to the Long-Term Care Consumer Guide.

“Mercy Franciscan at Schroder took immediate action to address the isolated situation that occurred in January 2010, including in-servicing and re-educating staff, and was back in compliance with state regulations after two days,” said Kelly Martin, spokeswoman.

The two nurses were fired after the incident, according to the Long-Term Care Consumer Guide.

Martin said during the same year, Schroder received family satisfaction scores above Ohio’s average in three categories including likelihood to recommend the facility.

As in the Hamilton case where a $5,700 fine was paid, most cases include fines ranging from $3,250 to $54,500. In two of the 14 cases, nursing homes were not fined.

At Hawthorn Glen Nursing Center in Middletown, two immediate jeopardy cases arose in January 2009, according to the Long-Term Care Consumer Guide.

One incident involved hot water in some resident rooms exceeding 120 degrees Fahrenheit — the American Journal of Pathology states third degree burns happen after 60 seconds of exposure to 127-degree water and 15 seconds of exposure to 133-degree water.

The facility implemented twice daily checks of temperatures in all resident rooms, as well as in-service training for staff on what to do if water temperatures exceed 120 degrees.

The second incident, just two days later, involved a male dementia patient abusing a female patient in the same ward by hitting her in the head, according to the Long-Term Care Consumer Guide.

It was discovered the same abuse occurred in December 2008.

Following the incident, the male patient was discharged and staff was trained on the definitions of abuse.

As well, all dementia patients were assessed to ensure they weren’t a threat to others.

In Oxford, similar to the hot water incident in Middletown, one immediate jeopardy case arose this March at Liberty Nursing Center on Fairfield Road.

Water temperatures were too high for three units — serving 19 residents, according to the Long-Term Care Consumer Guide.

The facility drained the water tanks and lowered temperatures to 120 degrees Fahrenheit.

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