Audio interview Pam Ott 6/06 re: skilled nursing

The following is a taped interview with Pam Ott, then former CEO/administrator, for KVHD.

This is regarding the year prior to the psychotropic restraint issues which have lead to three indictments.

The facility was not in compliance, paid penalties, and was not being paid for residents, and this was the 2006 survey.

This transcription does not contain the whole interview, but the portions regarding the SNF.

LH refers to my questions and responses and PO, is Pamela Ott.

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LH-This doesn't sound like just an annual survey thing because this stopped you from bringing in new patients.


PO-That was that whole restraint thing.

LH- When they came out for the regular, annual survey, they had a new criteria for the restraints?

PO- Right.

LH- They had a new criteria at that point and they said you're not following our new criteria?

PO- Because you are using restraints and they want all nursing centers to be restraint free. I know it's crazy.

LH- Are you going to have people on the floor?

PO- And they say that's okay.

LH-People on the floor with broken hips?

PO-No, they say you can keep them safe when they fall they won't hurt themselves if you protect their environment. If there's pads on the floor, low beds, pads on their hips, helmets if they're prone to falling on their head, (laughing) rubber walls...

LH-I guess you're going to have to throw them in a cotton room then?

PO-Yeah. Now here's what happened, they were sort of put under the gun a couple years ago when it was found that people were hanging themselves in their bed rails or in their restraints because they love to wiggle and they are all Houdinis; and they don't like being restrained so they try to do whatever they can to wiggle their way out.

And so people were hurting themselves with their own restraints which were supposed to be protecting them. So, they started doing this large study about how safe are restraints and believe it or not, with everything I've read, it's safer not to restrain than it is to restrain.

It's safer to let people fall- and they promise us that, I mean we have some people who are in restraints that the family said, if you take that restraint off and we'll sue you.
It was just a huge culture change. We had nurses in tears saying you can't do this to my resident I love, because they're going to hurt themselves.

It was a huge culture change. And that's really the bottom line is that you have to- apparently, from an attorney vantage point, there are enough studies done that say you're more likely to get sued for restraining than you are for not restraining and somebody hurting themselves, because it's standard of care now.

LH- So, this is the new standard of care?

PO- Correct

LH- This is pretty much big business here, the SNF?

PO- Well, that's the catch 22 is there, whether we were using restraints or not, we know that's safer then them being home alone. Without the kind of care that they needed, three square meals, and somebody to help take care of them.

(this is regarding the hoped positive outcome that patients will be admitted and paid by medicare again)

PO- So, we'll fill up pretty fast. And that's always the case here. We always have a waiting list, because the reality is no matter what about the restraints thing, we have a wonderful reputation.

(Two months after this interview, in Aug. 2006, Gwen Hughes was hired as the Director of Nursing in the Skilled Nursing Facility. Then, apparently, a different type of restraint was being used: psychotropic drugs. Now Ott is a witness for the state in charges against the SNF. Though, Ott herself, has a civil suit against her surrounding the same incidents. Here is her statement in the transcript from the state's case.)

On May 27, 2008, I interviewed Pamela Ott, former CEO/Administrator for KVHD. Ott stated that Gwen Hughes was the DON at KVHD when she was the CEO/Administrator. Ott stated that during the time DPH conducted their investigation in January 2007, she was informed of accusations from the staff that residents had been held down in order to give them forceful injections of medications.
Ott stated that the nurses came to her to voice their concerns with Hughes being rude and cruel to staff, but was never made aware of the psychotropic medications being used or Hughes threatening staff for refusal to administer these medications. Only after DPH conducted their investigation was Ott informed that KVHD resident, Louise Zimmerman, had been given a forceful injection of Respiridol without her consent.
Ott stated that she and her staff conducted a full internal investigation of the forceful use of psychotropic medication and found the accusation to be legitimate. The investigation found that Zimmerman was biting, kicking, and hitting others and that the IDT had recommended to Pormir the use of Respiridol to treat her. Their internal investigation found that staff were directed by Hughes to go into Zimmerman’s room to participate in administering the forceful injection to her. The internal investigation found that staff distracted Zimmerman. Then an injection was given to her without her consent. In this investigation, Pormir stated that he approved the use of psychotropics on Zimmerman.
Ott stated that there was a written report completed regarding this internal investigation.
This investigation is located at KVHD in the Quality Improvement (QI) file. Ott stated that she considered the incident in which Zimmerman received a forceful injection of psychotropics as elder abuse at the highest level.

That's not the way some people see it

Not that I know for sure if the state has spoken with any of the nurses and others who are about to be quoted regarding the knowledge of the board and Pam Ott, but these are certainly alarming facts that don't fit snuggly into the indictment. I have picked out a few quotes from my notes taken in May of 2007.

"By the second week in August staff was already calling in complaints to DHS."

"The hospital actually picked me up at lunchtime because they didn't want me to talk to the state."

(Regarding the incident when board members Kay and Bob Knight entered the nursing facility and was chased off by DON, Gwen Hughes, in her wheelchair running into Mr. Knight's shins with the approval of Pam Ott, who said, ordered her to get them out of there)

"Peg was in the SNF and stood up for Bob Knight. Pam ordered Gwen to write up Peg."

ONE MORE:

"When we told her about the SNF, she kind of hemmed and hawed, she really didn't want to know. She wanted to get rid of the people who know the truth."