According to an article on WRAL.com, the North Carolina Department of Health and Human Services (DHHS) has recommended that the Centers for Medicare and Medicaid Services fine Britthaven of Chapel Hill nursing home for violations that led to the hospitalization of six patients in February. One patient, 84-year-old Rachel Holliday, died.

Ms. Holliday and eight other patients tested positive for opiates, powerful and controlled pain medications–and many of them had not been prescribed opiates at all.

Angela Almore, 44, of 724 Berwick Valley Lane in Cary, was indicted in June on one count of second-degree murder and six counts of felony patient abuse. Almore worked as a registered nurse at Britthaven. Prosecutors allege that Almore drugged the patients to make them more manageable. [from WRAL.com]

After an extensive investigation, the DHHS Nursing Home Licensure Section found that Britthaven of Chapel Hill “didn’t ensure patients were protected from abuse, its services didn’t meet professional standards, unnecessary drugs were prescribed and significant medication errors occurred.”

The requested fines were $2,500.00 for each violation, for a total of $20,000.00.

HensonFuerst’s Nursing Home Abuse team continues to conduct an independent investigation into these and other episodes of nursing home abuse and neglect. If you have questions about potential abuse, we’re here to provide answers. Call us anytime, day or night, at 1-800-4LAW-MED.

In North Carolina, if a restaurant scores below a “C” grade for sanitary reasons during a health inspection, the business must close until it passes inspection.  If property owners allow their homes to fall into disrepair, the state can condemn the residence as unsafe, and in some cases, the building may be demolished.

But if a nursing home “fails” Medicare inspections…or if the facility has a history of unsafe practices, or of hiring workers who bring harm to the feeble and elderly residents, do you know what happens?

There’s a small fine. But that’s more than offset by the money Medicare will continue to pay into the nursing home on behalf of the patients living there.

Case in point: Britthaven of Chapel Hill.  This nursing home also has been rated by Medicare as one of the worst in the country. Britthaven of Chapel Hill has been called out as a “Special Focus Facility,” which means that they have a history of persistent poor quality of care. In February, six Britthaven patients were hospitalized from morphine overdose…one patient died of complications. A nurse has been charged with murder in that case.

And now, this article in Saturday’s News & Observer, and this article in today’s newspaper.

If you have legal questions about nursing home care, feel free to contact the attorneys of HensonFuerst. If you have questions, we have answers.

Today, June 15, is the 5th annual World Elder Abuse Awareness Day.

Sponsored by the International Network for the Prevention of Elder Abuse (INPEA), the first Awareness Day in 2006 involved several hundred organizations and governmental bodies throughout the world, on all seven continents. Their core message is this:  Never ignore elder abuse.

Throughout the world, abuse and neglect of older persons is largely under-recognized. It is an unspoken problem. Unfortunately, no community or country in the world is immune from this costly public health and human rights crisis.

Elder Abuse Facts

According to the World Health Organization, the elderly are especially at risk of abuse in institutions such as hospitals, nursing homes, and other long- term care facilities. In a survey in the United States, for example, 36% of nursing home staff reported having witnessed at least one incident of physical abuse of an elderly patient in the previous year, 10% admitted having committed at least one act of physical abuse themselves, and 40% said that they had psychologically abused patients.

Abusive acts include physically restraining patients, depriving them of dignity and choice over daily affairs, and providing insufficient care (for example, allowing them to develop pressure sores).

Signs and symptoms of abuse include:

• delays between injuries or illness and seeking medical attention;
• implausible or vague explanations for injuries or ill-health, from either patient or caregiver;
• differing injury accounts or case histories from patient and caregiver;
• frequent visits to emergency departments because a chronic condition has worsened, despite a care plan;
• laboratory findings that are inconsistent with reported treatment.

The HensonFuerst nursing home abuse team has seen first-hand the abuses that can be heaped on the elderly. Just a few months ago, six residents of the Britthaven of Chapel Hill nursing home were given overdoses of morphine, and one resident died. They were all in the Alzheimer’s unit, which means that they were helpless to know what was going on… helpless to fight back.

Stories like that are what keep HensonFuerst fighting against elder abuse every day of the year.

WRAL.com reports that registered nurse Angela Almore was indicted on a charge of second-degree murder for the death of an Alzheimer’s patient at Britthaven of Chapel Hill nursing home. Almore is also charged with six counts of felony patient abuse, and is being held in the Orange County jail under a $500,000 bond.

In February, nine Alzheimer’s patients tested positive for powerful opiate medicines, the kind used to control pain. Six of the patients were hospitalized, and one patient–Rachel Holliday–died.  At the time of her death, Ms. Holliday had a blood morphine level of 50,000 ng/ml… even though she had not been prescribed morphine.

HensonFuerst is relieved to know that the investigation into patient abuse at this nursing home will continue, and that an arrest has been made. Our nursing home abuse lawyers are continuing their own investigation of this incident. There are many more questions to be answered….

To read the full WRAL story, click here: Murder Charge at Britthaven of Chapel Hill. And if you have questions about what you can do about suspected cases of nursing home abuse, contact our Nursing Home Abuse team–if you have questions, HensonFuerst has answers.

An article on the WRAL webite today reports that an excessive amount of morphine contributed to the death of a patient in the Alzheimer’s unit of Britthaven of Chapel Hill nursing home.

In February, patients were drug tested when managers expressed concern about the way the patients were acting. Of 25 Alzheimer’s patients, nine tested positive for opiates. (Morphine is a type of opiate.)  Three of the patients were removed from the nursing home and hospitalized, and one of those patients–Rachel Holliday–died on February 16, 2010. On autopsy, the medical examiner found extremely high doses of morphine in Ms. Holliday’s system, even though she was not scheduled to receive that medication at all.

The North Carolina State Bureau of Investigation (SBI) is still analyzing evidence in the case; the medical examiner did not rule out homicide.

Everyone at HensonFuerst is outraged and heartsick at these findings, and our prayers go out to the family members affected. Britthaven of Chapel Hill has been providing substandard care for a long while, as evidenced by its Medicare rating: an overall 1 out of 5 stars. It is also a “Special Focus Facility,” which means that they have a history of persistent poor quality of care. Every patient deserves the best possible care, and Britthaven of Chapel Hill has not been keeping up with the implicit promise made by every special care facility: That they will take care of your loved one.

Obviously, there has been a serious disconnect somewhere along the way. Is the staff undertrained or incompetent?  Do the corporate heads not care enough improve the facility?

HensonFuerst is also investigating cases involving Britthaven of Chapel Hill nursing home patients receiving opiates. If you are concerned about a loved one who resides in this or any other facility, please give us a call. We want to help.

You can reach our nursing home abuse team by calling 1-800-4-LAW-MED.

The SmartMoney Magazine website published an eye-opening list of “10 Things Nursing Homes Won’t Tell You,” which was adapted from a book by Jonathan Dahl and the editors of SmartMoney.  Everyone related to a nursing home resident should visit the site, read the list, print it, study it, and post it somewhere visible.

So I don’t give everything away, I’ll include 5 items here (with our own commentary).

1. “We’re careless about the drugs we give out.” Some nursing homes have been cited for unnecessary drug use, use of antipsychotic medications among residents who are not psychotic, and overdosing residents so that they are easier to care for. We have seen this locally, when Britthaven of Chapel Hill nursing home was reported to be the subject of investigation when residents were given narcotic medications without a prescription, leading to the death of one patient.
2. “If it’s not in the care plan, we’re not gonna do it.” The federal government requires a care plan for each resident, which outlines how the resident should be cared for. Even if something is on the care plan, nursing homes can neglect the promised duties… but if a particular aspect of care is not on the plan, forget about it. Don’t assume anything.
3. “‘Neglect’ is our middle name.” When nursing home residents are neglected, they can suffer from dehydration, pressure sores, malnutrition, disease, and sometimes death.
4. “We use physical restraints on your loved ones.” Restraints are allowed as a method of last resort to keep a loved one safe or protect others. But that doesn’t mean that use of restraints isn’t abused, and can lead to depression, agitation, bruising, and other physical problems.
5. “Fines? Go ahead–give us your best shot.” When a nursing home doesn’t meet standards, it can be fined… but that doesn’t mean that the money will ever be collected. The facility can appeal the the citation and fine, or find other ways to avoid paying. Plus, corporations that own and operate nursing homes at the highest levels (because there are often shell companies that are the “face” of each facility) are usually so flush with cash that a little fine is barely noticed.

Want to read the rest of the list? Check out the original article here: SmartMoney Magazine.

HensonFuerst is an avid supporter of nursing home residents and their families. Our lawyers have been involved in some groundbreaking litigation that have made residents safer, and we continue to work for the benefit of the “little guy” against corporations who abuse and neglect senior citizens. If you think your loved one is being abused in a nursing home and you don’t know what to do, contact HensonFuerst. If you have questions, we have answers.

One of the many lessons of the still-developing story of Britthaven of Chapel Hill is that sick, elderly nursing home residents may be easy targets if the nursing staff wants to slip an extra pill or two into their patients’ medication allotment to ensure that the residents remain unresponsive and sleepy–a form of chemical restraint.

There is currently an investigation by the N.C. State Bureau of Investigation (SBI) about how patients in the Alzheimer’s unit of Britthaven of Chapel Hill wound up testing positive for strong opiate narcotic medications… drugs that had not been prescribed.  Several of the nursing home residents were hospitalized, and one died. (Read more and see our videos about this case here: HensonFuerst Britthaven videos and stories.)

The state of Massachusetts has a similar problem. According to the Boston Globe, nearly 2,500 nursing home residents were given powerful antipsychotic drugs that were not intended or recommended for their medical conditions. Data from the Centers for Medicare and Medicaid Services show that thousands of Massachusetts nursing home residents were given these psychotropic medications that–and here’s the similarity with Britthaven–could act as chemical restraints and had not been prescribed.

Earlier this year, the U.S. Department of Justice filed lawsuit against pharmaceutical giant Johnson & Johnson for paying kickbacks to Omnicare Inc., the nation’s largest pharmacy that specializes in dispensing drugs to nursing home patients. How did they learn about it? Good-hearted whistleblowers stood up and spoke for the helpless–and drugged–patients.  (Read more here: DoJ press release)

It’s all starting to sound like the plot for a movie: Kickbacks… chemical restraints… helpless patients… narcotics… lawsuits… whistleblowers.

It’s not a movie, it is the reality of our parents and grandparents, the people we love who can no longer care for themselves. We commend the whistleblowers, and anyone else who sticks up for nursing home residents. In our eyes, they are heros. The lesson for the rest of us is to monitor medications of our loved ones. If your family member is in a nursing home:

• Question every medication. Ask what it is, which doctor prescribed it, and what it is supposed to treat.
• Know the schedule. For each medications prescribed, know what the pill or capsule is supposed to look like, what dosage is prescribed, and how often the medication is to be taken. If it helps you to remember, take photographs of the pills–not all round, white pills are the same.
• Question changes. Don’t assume that a doctor authorized a change…if anything changes and you have not been informed, ask. Watch especially if the medication differs from day to day.
• Watch for side effects and changes in behavior. Is your loved one sleeping more than usual? Eating less? Acting “out of it” in ways that are unusual? It is common to assume that all changes are related to a disease… sometimes it is a side effect of medication.
• If you don’t get satisfactory answers, ask someone else. If your loved one is in immediate danger, call 911. And if you believe that your loved one is being abused, call a lawyer who can help you figure out what is going on.

It was horrifying to families that had already lived through the tragedy of having a loved one diagnosed with Alzheimer’s disease. As reported in the media, 9 residents of the Britthaven of Chapel Hill nursing home tested positive for strong pain medication–opiates–that hadn’t been prescribed to them…one later died.

Now, ENCtoday.com reports that the incident and the facility are under the microscope from the NC State Bureau of Investigation and the Medicaid Investigations Unit of the Attorney General’s office.  One new twist: the Kinston-based Britthaven “also has come under scrutiny for its financial contributions to political campaigns in recent years, thanks in large part to the efforts of Bob Hall, executive director of Democracy North Carolina.” (ENCtoday.com)

As reported:

According to WRAL, Britthaven employees and Britthaven’s parent company, Hillco, gave more than $175,000 to state political candidates during the 2004 and 2008 elections. The donations went to Republican and Democratic candidates equally.

Impressive. But that kind of political spending won’t buy Britthaven a way out of this investigation…and it certain doesn’t give peace of mind to families of current residents.

To learn more about nursing home abuse, and what to do about it, visit our website at www.lawmed.com.

A lovely article in the New York Times (“Old Age, From Youth’s Narrow Prism“) by Marc E. Agronin, M.D., describes how those of us who have not yet attained old age often make off-base assumptions about how the elderly think and feel. We project our own fears and beliefs onto them, while also presuming that we know what they must be thinking. We, the younger, are often wrong.

Can you remember when you were 13? To a teenager, people who are 30 are old, people who are 40 are ignored as impossibly old, and if you’re over 50? Well, life is over, right? Until you turn 30…40…50, and you realize that your older life is not at all what you had thought. How do you explain that to the teenager?

The same with old age. There are changes, to be sure, but there is also life. There is the potential for love and enjoyment. Even in a nursing home, as the New York TImes article so poignantly illustrates.

That’s yet another reason why the poor conditions at Britthaven of Chapel Hill Nursing Home are so disturbing. For years, this nursing home has be cited as providing substandard care, but according to Medicare reports, improvements are not made. That makes it a “Special Focus Facility.” And then came the reports of what seems to be inappropriate medicating of some Alzheimer’s patients with powerful opiates.

HensonFuerst has been at the forefront of fighting for the dignity and rights of people in nursing homes. This article is another reminder that “old” does not mean “oblivious.” Our elderly deserve to be nourished, their lives enriched, regardless of where they live.