The KVHD "elder abuse" case and the ABC News media abuse case
In the last four years of this investigation into the wrongdoings at the Kern Valley healthcare district which includes not only elder abuse (which is a general term not specific to chemical restraints), but other crimes such as "Brown Act" violations by three members of the board of directors; targeting employees for unwarranted termination because they wanted to tell the truth about the elder abuse caused by short staffing and peculiar new drugs being used by the Director of Nursing; a previous policy that reduced staff and pay leaving the skilled nursing facility understaffed and overworked (and patients underfed and underweight, according to government documents); use of the only local radio outlet to disseminate falsehoods regarding the situation at the hospital by a board member and disc jockey and CEO; a CEO without proper credentials who was in charge and giving orders to the management of the nursing facility; same CEO, Pamela Ott, misrepresented her credentials, claiming to be a nurse practitioner; threats from the CEO, Ott and board member, radio jock, Bob Jamison, (running off the ABC logo) of lawsuits against all who disagreed; malicious defamation, lies and deceit round off the list of incredible truths the have taken place in our rural, public hospital.
(Phhhew! That's some list for you, and I even left a few things out for brevity sake.)
Recently ABC News took up their own story of the Kern Valley Healthcare District, running a national news story on the day that defendants in the "elder abuse" criminal case went to court last week, Jan. 5, in the Kern County Superior Court.
It was simply a continuance of the matter last week in court as one of the defendants changed attorneys in the case and needed time to catch up on events, so the date was pushed out until March 9.
But as nothing is as it seems in this case, the attorney for Dr. Hoshang Pormir in the criminal matter is now not just any attorney, but we have a political celebrity in our midst with Donald Etra.
(Yeah, me too, I didn't know who Etra was and even went on to make a few cute remarks about his name, extra and et cetera, and even commented that he must be really "high powered" if he uses an "AOL" email address.)
That was until I received an email with a story about our new player. (I'm really good at looking stupid, so this is nothing new for me.)
As I gazed upon a picture of Donald Etra and his wife, Paula, posing at Camp David with friends, George and Laura Bush, I knew this was going to get even stranger. I closed the email and began my own search which lead me to several articles and even a site called "mucketymucks" which links celebrities to other people, like Etra is linked to Snoopdog and Fran Drescher too. (weee..)
More interesting is Etra's politics which he is purported to have called himself a liberal democrat. Not unusual except that he is supposedly a good friend and supporter of conservative democrat, George W. Bush.
He was a consumer advocate working as Ralph Nader's attorney, according to several of the articles I have read so far. (Interesting that he would be on this side of the case as a consumer advocate, but Mr. Etra is also known for defending death row criminals, according to background information contained on several different internet sites.)
Politics has come to this case, but it is bigger than I thought, as it would be very easy, or I should say, is easy to get your name out there on a "shock value" story such as the one being told by the attorney general of the state of California, Jerry Brown.
Could our elder abuse case get him elected to the governor's mansion? Again?
However, let's start with some background on the case, unlike ABC news, which we will deal with shortly, so we can catch up to this ever changing story which is occurring right now, not almost four years ago Diane Sawyer...
Jerry Brown's scare job on chemical restraints
As some know, the use of psychotropic medications sometimes referred to as, "chemical restraints" when used in an institutionalized setting, are really two different issues entirely.
Psychotropic drugs are not unusual to find in nursing homes, rehabilitation centers, try calling around, they are part of the arsenal against the horrible nature of some of the geriatric illnesses such as Alzheimer's, dementia, Parkinson's disease, and other disorders which can make the elderly patients altered, frightened, and uncomfortable emotionally and physically.
And then you have the issue of medicating "violent" patients who are unaware in their psychosis that they are acting out and hurting staff and other patients. It's not really the patient him or herself, it's the diseases of age or injury which turn loving spouses, parents, grandparents, into raging, violent, out of control and sometime dangerous people.
It's a tough call as to how to treat these patients so they have their dignity, compassion and effective care for the last part of their lives.
Anyone who has had to take care of a grandparent or parent or even in certain cases younger people who have brain injuries or degenerative diseases, knows that it is a full time job and nothing about it is ever perfect.
My grandmother turned very violent, breaking windows, attacking people, and was too much for us to handle at home. We tried for a time, but it became dangerous for all involved.
So, we took my violent grandmother to a facility where she could be monitored and live peacefully with caring and professional people helping us with the situation.
She was immediately put on a drug, not used in this case, but one that could make people wonder if it was not a chemical restraint, "Haldol," which is an antipsychotic, not used much anymore, as newer, safer, drugs have come along to replace that generation of drugs.
My grandmother responded well to the drug, and was no longer violent, but was much more sleepy and tired but even occasionally smiled. My grandmother it was later found had Alzheimer's.
I'm glad they gave her the drugs, they made the last obviously horrible part of her life more tolerable. I would rather have seen her sleep then grapple with her invisible demons which would set her off into fear and violence.
The situation was though that my grandmother was 92 years old, and the drugs were going to have an effect which may have shortened her life. She lived to be 102 years old, ten years after she was psychotic and put on antipsychotic drugs.
We made that choice. I call it a choice as there is little alternative out there, but we knew and accepted the situation.
The choices are slim, and must be well thought out by a combination of family and medical staff working together to make the last days, months or years, (sometimes people live a long time in a vegetative state due to illnesses like Parkinson's and Alzheimer's.) as pleasant as they can be for "all" involved.
At KVHD there were no choices
But such as what happened here at the Kern Valley Healthcare District in 2006 was a breakdown in management systems, because the leader, the CEO, the administrator who signed off on the skilled nursing facility, did not have the background to be running that operation.
In fact, the credentials we have found to be true and correct, is that the CEO, Pam Ott, had a current registered nursing license in California which came from a Fresno City College degree she received, which was an AA, back in 1971.
Not only were the systems outdated and the procedures in place ineffective at the beginning of 2006, but families were being pushed out, not allowed to know what exactly was going on. They weren't given their choices.
It's not just about chemical restraints
A chemical restraint would be a medicine which reduces a patient's psychosis or altered thinking and behavior, thus allowing the patient more freedom from the symptoms and obviously allowing them the chance to be more interactive and even potentially able to help themselves again.
However, these drugs or any drugs should not to be used as a babysitter, which is what is being claimed in the criminal case here in the Kern River Valley.
In April of 2006, four months before the investigate period by the California Department of Justice, which includes August 2006 until January 2007, the Kern Valley Healthcare District was cited by investigators in the nursing center's annual survey by the Center for Medicare/Medicaid Services, CMS, for using "physical" restraints on the residents.
But that claim was not as ominous as the results of what was happening in the nursing center before the six month time period delineated by the Department of Justice, DOJ, office of Medi-cal fraud and elder abuse.
Months before the August start date of abuse (I guess that's what the state might call it) there is paperwork indicating the nursing center is short staffed, not fulfilling it's nurse to patient ratios, which obviously would cut back on the ability of the unit to properly monitor it's patients.
Indeed that was the case, as residents had lost significant amounts of weight, and were even noticeably dehydrated by the investigators from public health who do the annual evaluations for CMS on nursing centers.
(There are many pages from these reports on this blog. Please look up short staffing and physical restraints, it will give background, and actual documentation)
The administrators of the skilled nursing facility were also being questioned in April of 2006, as Pam Ott, CEO, did not have a Nursing Administrator's license, and indeed she did not need one in a facility where the nursing facility is part of the hospital.
But public health pushed that issue and Ott sent the inquiry to the hospital's board attorney, Scott Nave, who came back with the answer that Ott indeed didn't have to have those credentials to sign off as administrator of the SNF.
Ott, in a letter she signed to CMS, indicates that she is "not" the person in charge of the nursing facility: the person in charge is Sharon Brucker, RN, and former Cheif Nursing Officer.
Brucker has not been charged in the elder abuse case, though Ott was a late arrival, being brought in six months after the initial arrests of three defendants, a doctor, pharmacist and director of nursing, and according to the press office for the DOJ, the investigations are on-going.
You must have a DON
One of the corrections public health demanded of the hospital early in 2006, was the need for a Director of Nursing for the nursing home portion of the hospital.
At this point, according to employees of the time period in 2005/06, the previous director of nursing, who seemed to be well liked by the employees, left the employ of the hospital because of a disagreement he had with the CEO, Ott, and the Cheif Financial Officer, Chet Beedle, over paycuts and staffing problems.
Now this is according to several nurses who worked with this DON at the time, not from the hospital or the DON himself.
The hospital did not have Director of Nursing for the SNF, so public health insisted that KVHD hire one.
And Lucy Miller was transferred into the nursing center a week later.
Ott signed off that the hospital was in compliance by bringing in a DON.
Miller, didn't stay long, just long enough to comply with the state and federal mandates from the annual survey.
An ad in the classifieds
Miller left, or actually changed jobs within the hospital, and an ad came out shortly after, for a Director of Nursing for the SNF.
We, the media, the board of directors, heard that there was a new DON ready to take charge of the skilled nursing facility, Ott announced we were waiting and very excited about our new acquisition.
"She has more than 30 years with geriatric experience," Ott told us, and we were impressed.
In August of 2006, our new DON, came on, her name is Gwen Hughes. She is now charged with eight counts of elder abuse 368 B (1) and two counts of assault which was a result of medicating a resident against her will.
But in August 2006, Hughes was the hero, coming into a nursing center which had been recently beaten up by the state investigators over the use of the physical restraints, the short staffing, the lack of monitoring the weights of the patients, and even a few issues regarding medications, psychotropic.
"We are so lucky to get her," Ott told me as I was introduced to Hughes, who was in a wheelchair, and rather quiet as I asked some simple questions, like "what brings you to our little town?"
Hughes told us she had polio at one point in her life, but was still able to walk without her wheelchair, so we should not think it a miracle if she arose and began walking.
In conversations which were to follow the thing we kept hearing about Hughes from our CEO, (who herself, had funny credentials from a diploma mill called Kennedy/Western University, an on-line program, unaccredited, and not accepted in California,) was that Hughes was an expert in "geriatric medications."
(Now, how would she know an expert?)
Part two: the IDT team
Persistance and Tenacity, requires a new chapter, a new beginning....
No comments:
Post a Comment