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.

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.

In response to continuing reports of deaths, abuse, and substandard care at long-term nursing facilities, the Senate Finance Committee has opened an investigation. The company in the spotlight is Select Medical Corporation, a for-profit long-term care provider with 89 facilities in 26 states, including North Carolina. (They own Select Specialty Hospitals in Durham and Winston-Salem.)

The investigation will focus on the deaths and poor treatment of seriously ill patients. According to a an article in the New York Times, these hospitals treat 200,000 patients each year, but rarely have full-time physicians on staff. In one particularly disturbing example, a dying patient’s heart alarm sounded for 77 minutes before nurses responded.

I think we can all recognize that this is horrendous care, but some people may wonder why the government would bother to get involved…and why the Senate Finance Committee. The answer comes down to funding.

The [Senate Finance] committee has substantial power over long-term care hospitals because it oversees Medicare. The federal program spends almost $5 billion annually on the hospitals, providing about 60 percent of their total revenue. (quoted from the New York Times article by Alex Berenson.)

While it is always heartening to see investigations into specific companies that are doing wrong, it looks like this particular issue may have widespread benefits for all of us:

In a separate letter, the senators asked that the Government Accountability Office, Congress’s investigative agency, examine federal and state oversight of all long-term care hospitals, saying that they worried the facilities might expose patients “to an unreasonable risk of harm.”

Finally…hope for reform, from Medicare on down!

Medicare has announced that it will stop paying for negligent medical mistakes that are “reasonably preventable”.  This will include injuries from falls, serious decubitus ulcers,  and other common signs of abuse and neglect that are seen in nursing homes.  The New Your Times covered this announcement, click HERE.