Wednesday, September 17, 2008

NC's Mental Health DISGRACE

License yanked for assisted living home
Woman still missing from facility

Cleveland County officials spent Friday scrambling to find new homes for 60 Unique Living residents after the state's decision Thursday to suspend the adult care home's license.
State inspectors ordered the troubled facility to cease operations by midnight Friday after concluding that conditions put residents in imminent danger.
By Friday afternoon, Cleveland County officials had moved all 60 residents to new homes, mostly adult care homes in counties including Cleveland, Lincoln, Gaston, Iredell, Mecklenburg, Davie, Yadkin and McDowell, said Cleveland County Department of Social Services Director John Wasson.
"I think given the time we had," Wasson said, "we did a really good job."
State regulators found staff at Unique Living "weren't properly supervising residents in terms of their comings and goings," said Jeff Horton, acting director of the state's Division of Health Service Regulation.
The action follows last week's disappearance of Mouy Tang, a 46-year-old insulin-dependent woman with schizophrenia. She's still missing.
Unique Living can appeal the license suspension.
History of problems
The home, in Fallston, about 50 miles west of Charlotte, has been repeatedly accused of poor patient care and unsafe conditions.
Its problems point to a flaw in North Carolina's mental health system. Unique was meant to house elderly or disabled people who need help with activities such as bathing, dressing and feeding.
In fact, it houses mostly residents with mental illnesses, because North Carolina doesn't have enough housing options or services for those citizens.
Unique Living's problems date back several years. Until 2005, the facility was called Yelton's Health Care.
After one resident died from choking on a sandwich and another died from scalding in a tub, Yelton's closed and reopened in 2005 under different ownership -- the former owners' programming director, their son and his girlfriend -- as Unique Living.
It kept the same residents, but the switch erased Yelton's history of violations.
In 2006, the home was fined $16,000 after a man with diabetes and dementia wandered from the facility and died.
In June, the Cleveland County Department of Social Services told the state that utilities were threatening to cut services to the home because of nonpayment, and that water had been turned off for five hours in April. The department asked the state to take over management of the facility, warning it was "only a matter of time" before a resident was injured or harmed.
In July, state inspectors responded to county concerns with their own inspection. They found numerous violations, including door alarms that weren't operating, soiled and ripped mattresses without sheets and stained pillows without pillowcases. But they concluded the violations weren't severe enough to warrant a license suspension or management takeover.
Though Unique Living's main building will soon be empty, about 22 residents remain in trailers on the property. Those trailers aren't affected by the license suspension because they're licensed as mental health group homes.
Warnings not heeded
Family members of Tang, who disappeared Sept. 3 and has not been found, have faulted state officials for failing to heed the county's warnings.
State inspectors visited again after Tang wandered from the building. This time, they found "evidence of neglect and failure to protect residents from potential harm," according to the suspension letter. As of Thursday, they hadn't released written findings.
Wasson, the county's social services director, said the transition to new homes could have been easier had the state adopted the county's request to take over management of the facility. He acknowledged, though, that closing the building was the right decision. "This facility was just unmanageable and untenable."
Prayers for safe return
Tang's niece, SueLee Waller of Raleigh, said Thursday she was relieved residents were being moved. "I hope all the residents who have to leave will find better homes," she said.
Charlotte's Kristen Foundation for Missing Persons has stepped up to help family members search for Tang. On Friday they passed out fliers in uptown Charlotte. They soon hope to put up a billboard with Tang's picture.
"We are just praying for Mouy's safe return," said Quynh Tang, her sister-in-law

N.C.'s mental health disgrace: Nowhere to go but up
There's no way to comprehend how a patient in a psychiatric hospital that's been warned for months about unsafe conditions could have been allowed to sit in a chair for 22 hours without food or help while staff members in the room played cards and watched television.
The patient's experiences sound like something out of a horror movie. Doctors weren't notified that he had fallen and hit his head while choking on medicine, nursing staff members failed to follow doctor's orders to check his vital signs and give him fluid and hospital workers were caught falsifying his medical records, a report in the Raleigh News & Observer.Steven Sabock, 50, died of a heart problem about 22 hours after being left in a chair in the dayroom at Cherry Hospital.Thanks to this and other incidents, the Goldsboro hospital becomes the second state psychiatric hospital to lose its Medicare and Medicaid certification, a move that will cost it an average of $800,000 a month in federal insurance payments. That's money state taxpayers will have to make up unless Cherry's $73.8 million annual budget is cut, an option that's apparently being considered based on comments Leza Wainwright, director of the state mental health division, made to the News & Observer.Broughton's troublesBroughton Hospital was decertified last August, following an investigation into the care of two patients. It regained its certification nearly a year later, but in the meantime the state had to pay $1.2 million a month to care for patients who otherwise would have been covered by Medicaid or Medicare.The state's mental health system has been in chaos since state lawmakers passed legislation in 2001 to revamp it. While their goals of privatizing services to give consumers more choice and of getting people out of state-run hospitals and back into their communities were laudable, underfunding, poor planning and mismanagement utterly undermined the effort. In fact, the exact opposite of the objectives has resulted. Records show that the number of mental patients checking into state hospitals for short visits grew by 83 percent from 2001 to 2005 as a result of dwindling local services and treatment space at community hospitals.A recent report commissioned by N.C. Department of Health and Human Services Secretary Dempsey Benton said the state needs to hire more than 700 people to make its psychiatric hospitals safe.Discord over hiringBut during the most recent legislative session, Benton asked the legislature for only enough to fund about 200 new staff members, saying that was about the maximum the hospitals could hire and train.Dante Strobino, with the N.C. Public Service Workers Union, disagreed."People are looking for jobs out there," he said.Strobino also said salaries need to be raised to attract and keep good people.Staff shortages may well be part of the problem, but staff shortages don't explain workers watching television and playing cards while a patient sits in a chair for 22 hours without food or help.The state's elected and appointed officials have known about the appalling conditions at North Carolina's psychiatric hospitals since before Broughton lost its Medicare and Medicaid certification more than a year ago. How can it be that nothing has been done to rectify the problems at Cherry in all that time?If hiring more staff and paying them more will help, that certainly seems a more cost-effective and compassionate measure than paying a million dollars a month to compensate for lost Medicare and Medicaid reimbursements.Disturbing cultureBut the problem appears to be broader than that. There seems to be a culture of mistreatment that has been tolerated to a shocking degree.It's hard to say who's at fault for that, but one thing is certain, the Department of Health and Human Services, which oversees these hospitals, is responsible for changing it and state lawmakers are responsible for seeing that they do. (Kelley, The Charlotte Observer)

No comments: