Another Troubled Facility
Northgate Care Center, a nursing home in Waukon, Iowa was recently added to the Centers for Medicare and Medicaid Services’ list of candidates for special focus facility status. Being a candidate for this list is no high honor to be sure, as it reserved for homes with serious care problems.
Only two nursing homes per state can carry special focus status, which is similar to a probation.
At Northgate, Iowa inspectors blamed consistent medication and staffing issues for its addition to the candidate list. Residents reported waiting up to two and a half hours for their call lights to be answered, and medication rules were frequently broken by staff.
One of the most tragic instances of the latter occurred when a resident had been given medications meant for another resident, including melatonin, an antidepressant, an anti-anxiety medication, and an anticoagulant. The resident then stood up from a recliner and fell to the floor. She was taken to a hospital, where an X-ray revealed a broken leg.
Inspectors said the resident’s family chose to forgo surgery. She was transferred to hospice care and died within days. Northgate was also faulted by state officials for the failure to properly assess and treat her after the fatal mix up.
A licensed practical nurse later acknowledged the error. At the time of the incident, she had told the emergency room that the resident had received only one wrong medication rather than four. She later said that her dishonesty was because she realized her mistake.
Even after this incident, four of the home’s seven nurses were engaging in a practice frowned on by state officials: setting up patients’ medications hours in advance. Officials warned them that this could lead to handing out the wrong medications. Nurses continued, saying that they were understaffed and would not be able to complete their work without getting medications ready far ahead of time.
The actions and omitted actions of nurses often lead to neglect and wrongful death in nursing homes, but they are not the root cause. For that, remember the famous Latin phrase cui bono, or, “Who benefits?”
Case in point: The home’s medical director gave inspectors an explanation, saying, “economics only allows the facility to staff a certain way.” In addition, he said that he was unsure how to fix the problem.
Northgate is among Iowa’s 12 lowest homes for staffing, ranking at 39.9% below expected levels. Such low levels could only be intentional.
As we have covered in previous blog post, nursing home operators have an incentive to understaff: by cutting hours and encouraging massive turnover, the executives who run nursing homes enjoy higher profits.
It’s a cliched picture with an added element: the rich get richer, the poor get poorer, and the elderly suffer. All of this has been well documented through academic studies, reporting by journalists, and through nonprofits spreading awareness.
At Poliakoff & Associates, P.A., we are dedicated to fighting nursing home negligence in all its ugly forms—clinical and corporate.