Mass. Nursing Home to Get Coronavirus Patients

By Walter F. Roche Jr.

Owners and employees of a nursing home chain with a unique arrangement to care for Massachusetts victims of the coronavirus pandemic donated over $20,000 to the campaigns of Massachusetts Gov. Charles Baker and Lieutenant Gov. Karyn Polito.
Under an agreement disclosed Friday coronavirus patients being released from Worcester area hospitals will be cared for at the 164-bed Beaumont Nursing and Rehabilitation Center also in Worcester.
Beaumont disclosed Friday that the 147 patients now at the Worcester facility are being transferred to other Beaumont and Salmon nursing homes, a move which has prompted protests from relatives of some of those patients who are about to be moved.
Campaign finance reports show Matthew Salmon, Beaumont's chief executive officer, and other members of the Salmon family, have been regular contributors to Baker's and Polito's campaign committees.
The Salmon family has been generous contributors to other state officials including Sen. Michael Moore, a Millbury Democrat, and House Speaker Robert A. DeLeo, Democrat of Winthrop.
A spokeswoman for Beaumont and Salmon referred all questions to Beaumont's facebook page which includes a video from Matthew Salmon announcing the impending transfers.
"At this time, we are directing all inquiries to our Facebook page," Maggie Bidwell of Beaumont wrote in an email response to questions.
According to that announcement the 147 current patients are being transferred to other Beaumont facilities or other nursing homes with vacancies in the Worcester area.
Unanswered were questions including how much will be paid for each coronavirus patient and who will pay.
Questions directed to Baker's office also went unanswered.
In the video presentation Salmon said deciding to go forward with the agreement was "a very, very difficult decision" that he anguished over. He said the move was necessary to protect the current residents who would be put at risk when coronavirus patients were admitted.
He said all of the current patients would be moved by Wednesday. He also said the arrangement carried substantial financial risk.
Relatives of those current residents protested the sudden transfers and expressed concern that the disruption could have tragic results.

VA IG: Suicidal Vets Cases Mishandled

By Walter F. Roche Jr.

A Pennsylvania veteran who should have been contacted for possible follow up mental health services on two separate occasions never was contacted and committed suicide about three months after being cut off from services, according to a report from the Veterans Administration's Inspector General.
The 19-page report on services provided at the Coatesville Veterans Administration Medical Center also found that in a more recent case another veteran also with a less than honorable discharge was improperly denied an extension of mental health services because a chief of staff failed to review the veteran's actual records.
The information on the veteran who committed suicide in 2018 surfaced in the course of investigating a complaint filed in the more recent case.
The suicidal veteran had sought assistance in the Fall of 2017 and was granted 90 days of emergent mental health services and subsequently received both in-patient and out-patient services.
The patient's eligibility expired on Dec. 27, 2017.
The veteran, however also qualified for a program called REACH VET and, as a result, should have been contacted for possible follow up services. The program was established to provide assistance to veterans judged to be at high risk for suicide. Though notices of qualification surfaced on two separate occasions, no contact was made because VA staffers assumed the patient was getting care in the private sector.
"The OIG was unable to determine whether outreach would have prevented the patient's death because of unknown factor's related to the patient's death," the IG reported.
In the more recent case a veteran with a history of mood anxiety and substance use disorders was granted 90 days of emergent mental health services and first received in-patient treatment at the Philadelphia VA Medical center.
Subsequently the patient was in an outpatient rehabilitation program under the Coatesville center.
Though the veteran had sought an extension, he wasn't told until two days before losing eligibility in May of 2019 that his request was denied.
The IG found that the chief of staff handling the extension request never looked at the veterans electronic health record and was unaware that the patient was eligible for extended services under the REACH VET program.
"The chief of staff was unaware of the patient's REACH VET status and acknowledged the REACH VET status would be an important factor to consider in the extension request decision," the report states.
The chief of staff also acknowledged giving a "less than careful" review of the veteran's record.
The report also was critical of the way the veteran was informed at the last minute that his extension request had been denied.
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Hospital Hit for ER Violations

By Walter F. Roche Jr.

A suburban Philadelphia hospital has become the third in a month to be cited for requiring suicidal patients in an emergency room to wear distinctive scrubs.
Mercy Catholic Medical Center in Darby required patients in the emergency room with suicidal ideations to wear blue paper scrubs.
The requirement surfaced during a late January visit to the 188-bed facility by surveyors from the state Health Department.
A Mercy employee told the surveyor the paper scrubs were used to decrease the risk of strangulation by use of the ties on the scrubs. The surveyors also were told the distinctive scrubs made identification of suicidal patients easy.
The report states that use of the blue paper scrubs violates the privacy rights of the patients.
Previously the state cited the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center for placing patients deemed at risk for suicide to wear distinctive apparel. All three were inspected in January.
The inspection of the Mercy emergency room turned up other rules violations including a renovation project of three rooms for suicidal patients. According to the report the hospital undertook the renovation project and put the rooms into use without first getting state approval.
The report also cites a memo from hospital administrators to staff informing them that the hospital failed to meet the standards required by the City of Philadelphia to operate a Crisis Response Center.
"As a result," the memo states,"we have voluntarily relinquished our license to operate the CRC effective Nov. 5, 2019."
"We continue to fall short of necessary requirements to operate the center," the memo continues.
The hospital filed a plan of correction in which it promised to find new attire for suicidal patients and to file for formal approval of the renovation project.

Hospital Cited on Serious Events

By Walter F. Roche Jr.

A Montgomery County hospital failed to report to the state that four of it patients had to be transferred to other facilities due to changes in their health status.
In a report just made public by the Pennsylvania Health Department the four patients at the 305 bed Eagleville Hospital were transferred to emergency departments of other facilities. Three of the four occurred in February.
In all four cases, according to the report the patients required additional health care services and transfer to a higher level of care.
In a plan of correction hospital officials disputed the charge that the transfers amounted to serious events, but agreed to report them in the future under the provisions of the Medical Care Availability and Reduction of Error Act.
Records of the patients transferred showed one was found unresponsive while another fell and suffered seizures.
The facility also was cited for failing to get a written physician's order for a patient placed in restraints and for failure to include patient grievances in the records of six patients who filed complaints.
Contact: wfrochejr999@gmail.com

Covid-19 Virus Outbreak About to get Worse

By Walter F. Roche Jr.

A physician who heads a national research group says the effort of the Trump administration to initially downplay the significance of the now ongoing coronavirus pandemic already has had disastrous results and things are likely to get worse.
Dr. Michael A. Carome, director of the health research group at Public Citizen, said the efforts to downplay the outbreak led to a lack of planning and resulted in a failure to deploy test materials in advance of the virus' arrival in the United States.
"The response has been disastrous," Carome said in an interview. "The failure to deploy testing materials early has left us blindsided. People are going untested."
He said the United States should have followed the example of South Korea where testing materials were immediately available giving the healthcare system time to respond.
Calling the current crisis "one of the greatest public health debacles in the history of the country, Carome cited current Covid-19 hot-spots in New York, California and Washington.
"We have a health care system that is about to be overwhelmed," Carome said adding that the situation is only going to get worse as supply problems with such items as masks just magnify.
Stating that the Centers for Disease Control and Prevention's first attempt at a diagnostic test failed, Carome said that helps "explain why we've reached this state so soon ... and it's going to get worse."
He said the CDC made matters worse by declining to accept diagnostic tests offered by other countries.
He said health care providers in the United States may soon face the dilemma now being faced by their counterparts in Spain; taking ventilators away from the elderly and giving them to younger pandemic victims deemed more likely to survive.
He said his organization has joined with other advocacy groups in calling for accelerated efforts to find a Covid-19 vaccine. They also have called on the federal Occupational Safety and Health Administration to set an emergency standard for proper safety equipment for health care workers.
The organization has also called for paid sick leave for victims of the pandemic.
As for how long the current pandemic will last, Carome said while there has been speculation that warmer weather will bring relief "we just don't know."
Contact:wfrochejr999@gmail.com

2 PA Hospitals Cited on Medications

By Walter F. Roche Jr.

Two central Pennsylvania hospitals have been cited for medication errors in reports recently made public by the state Health Department.
Holy Spirit Hospital in Camp Hill and WellSpan Surgery and Rehabilitation Hospital in York were the subject of the critical inspection reports. Neither of the reports indicate whether the errors resulted in patient harm.
At Holy Spirit Hospital a Feb. 5 review of the records of a patient showed the wrong dose of a blood pressure medication, Labetalol, had been administered intravenously on Dec. 23.
The hospital filed a plan of correction in which it promised install an alarm system to warn staffers of a possible error. Hospital officials did not respond to a request for comment.
At the WellSpan facility during a January visit a state surveyor observed that before a medication was actually administered a patient's record showed it had already been delivered.
A day later the inspector observed a staffer administering a medication without first scanning the medication as required by hospital procedure.
Further review showed the medication was administered two hours later than ordered.
Other violations observed during an annual Medicare certification review showed food placed in storage was undated and other foods were stored without adequate protection.
A WellSpan spokesman said the hospital did file a corrective action plan that was accepted by the state.
"WellSpan takes the findings of the Pennsylvania Department of Health inspection report seriously," the spokesman said, adding that the plan of correction has been implemented "to ensure that we are in full compliance."

PA Veterans Home Out of Control.

By Walter F. Roche Jr.

One resident was punched in the face while a woman was grabbed by the wrist, dragged from her bed and pushed up against a wall. Another resident grabbed a worker around the neck.
Those were just some of the violent incidents detailed in a recent report from the Pennsylvania Health Department on multiple violations of state and federal standards in a state run nursing home for veterans.
The health agency surveyors concluded that the Gino J. Merli Veterans Center was out of compliance with the requirements of the federal Medicare and Medicaid programs and "lacked the resources" to meet the needs of its current residents.
In one incident cited in the report two residents got into an altercation after one of them wandered into the other patient's room. When the resident tried to push the intruder away, the intruder stood up from his wheelchair and punched the other in the face.
The multiple incidents involving severely impaired residents, some diagnosed with dementia, paint a picture of a facility out of control.
A female patient with a history of falls and requiring toileting assistance was left for hours without aid even though she had just suffered another fall a day earlier. She fell trying to reach the bathroom breaking her hip.
The report cites the home for failing to implement interventions to meet the patient's needs.
"The facility failed to provide timely and necessary staff assistance to meet this resident's assessed and identified level of assistance with toileting to prevent a fall with serious injury," the report states.
In a September incident a dementia patient became agitated when a staffer tried to intervene. The patient tried to throw his wheelchair at the worker. The same resident just days later placed his hands around a worker's neck.
Three days after that the same resident grabbed a woman lying in her bed, dragged her by the arm and pushed her up against a wall. The woman was yelling,"Help me," according to the report.
The male resident was finally transferred to another facility in early November.
The report also cites the facility for failing to properly care for an Alzheimer's patient at high risk for bed sores. The patient suffered a deep tissue injury
There was no documented evidence needed treatment was implemented, the report states.
The center was also cited for failure to screen three new employees and failing to provide mandatory in-service training for nurse's aides.
The facility officials filed a plan of correction in which they said protocols for handling dementia patients with behavioral issues were revised. The management also promised to conduct audits to ensure compliance by staffers.
The plan also calls for retraining sessions for staffers and revising the care plans for patients including the woman who fell and broke her hip.
Contact: wfrochejr999@gmail.com

Bucks Hospital Cited in Sex Assault Cases

By Walter F. Roche Jr.

A Bucks County hospital has been cited by Pennsylvania health officials for failing to document that it followed required procedures with patients who were victims of sexual assaults.
In a report made public this week, state Health Department surveyors said employees at the Lower Bucks Hospital failed to document that two victims of sexual assault were provided with the correct discharge instructions.
In addition the report states that documentation was lacking to show the victims were told about the need for subsequent testing for the presence of sexually transmitted diseases. The surveyors also noted that the records for the same two patients did not include the results of tests performed at the hospital.
Other items cited by the state were cases in which patients were put in restraints without a justifications being included in the patients' individual care plans.
The 175-bed hospital also had failed to establish a protocol for staffers to follow following exposure to MRSA, a drug resistant bacteria, according to the report.
The failures were noted in a Jan. 28 license renewal survey of the Bristol Pa. facility.
Michelle Aliprantis, a hospital spokeswoman, said the findings "were primarily related to documentation and there were no findings related to patient care."
She noted the hospital did file "comprehensive action plan" which was accepted by the state.
That plan calls for a staff re-education program for staffers on the proper handling of patients who were victims of sexual assault. The plan also calls for the establishment of protocols in cases where staffers were exposed to infections. The plan also calls for periodic audits to ensure that the corrective action plan is being followed.
Contact: wfrochejr999@gmail.com

Hospital Cited in Paraplegic's Treatment

By Walter F. Roche Jr.

A Pennsylvania hospital has been cited by state health surveyors for multiple errors in the treatment of a paraplegic suffering from a bladder infection.
In a report dated Jan. 23, state health investigators said the patient at the Moses Taylor Hospital was suffering from cystitis of the bladder apparently due to a catheter that needed to be changed.
But it was a full seven days after his admission that the old catheter was removed. At that time a full two liters of urine were collected from the patient.
The hospital failed to ensure "a catheter was changed in a timely manner," the report states.
According to the report errors in the case began when the patient was brought by ambulance to the emergency room on Dec. 19. Nurses at Moses Taylor did draw up a list of the patient's medications, but failed to record when the most recent doses were administered.
In addition to suspected cystitis the patient at admission was suffering from chronic pressure ulcers. He also was diagnosed with pneumonia.
State investigators reviewed the patient's records and reported that on Christmas eve leakage was noted around the catheter. A urology consult was requested the same day and again on Christmas day. On Dec. 27 the records show the patient was still waiting for a urology consult. Noting that the standard of care called for a consult to be made within 24 hours, the report states that a new catheter was finally installed on Dec. 29.
Other deficiencies cited include failing to perform a prescription drug reconciliation, failing to obtain a sterile urine specimen. in addition despite the patient's paraplegia and bed sores, records showed the patient was not turned every two hours. He had two stage pressure sore, records showed.
The 214 bed hospital is part of the Community Health System.
The hospital did file a plan of correction in which it promised to re-educate staffers on drug reconciliation procedures and consultation requirements. The hospital also agreed to perform audits to ensure the plan of correction is being implemented.
Hospital officials did not respond to a series of questions about the state report.
Contact: wfrochejr999@gmail.com
Contact: wfrochejr999@gmail.com