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Excerpts from a complaint summary on a fall by a Brooke Nursing Center resident Oct. 31, 2004. |
Sherry Robinson's mother couldn't take care of herself anymore. As much as Robinson said she didn't want to do it, last year she moved her mom into Brooke Nursing Center.
"The only reason I put her there is because it was close to home," said Robinson, a Stafford County resident. "But it was awful, absolutely awful. It was like my mom was a person there in bed waiting to die."
Robinson wasn't the only one to complain about the treatment of a family member at the nursing home in rural eastern Stafford.
According to the Virginia Department of Health, from 2003 to 2005 there were eight written complaints, four of which were substantiated.
Problems and complaints at Brooke led to passage of emergency state legislation this year, allowing a proposal to replace and expand the Brooke center at another location in Stafford.
The typical process for a new nursing home includes a request for proposals by the health commissioner, but the legislation bypassed that requirement in this case.
Del. Mark Cole, a Spotsylvania County Republican who represents part of Stafford, said he proposed the emergency legislation because he believes Brooke should be replaced and the number of beds increased from 34 to 90.
"The facility is too small and needs to be upgraded," he said recently. "I just put the legislation in to jump-start the process."
The proposal for a nursing home to replace Brooke was made by Smith/Packett Med-Com Inc. on behalf of Stafford Health Investors LLC and was approved in June by a regional health advisory agency.
The investors group would buy Brooke's 34 beds and add another 56 at a proposed site near Celebrate Virginia North off U.S. 17 in southern Stafford. The county would require rezoning for a nursing home in that area, and public hearings on the issue could be held in the next few months.
Along with finding a place for the new building, S/P and SHI are waiting for approval from the state Health Department and the health commissioner, which are expected before December.
If the nursing home gets the go-ahead, they say it will take about two years to open.
Pressure for replacementIn addition to complaints about patient care, Brooke Nursing Center's future is uncertain because of the age and condition of the building and its water system.
The nursing home's administrator, Martha Cottingham, said they're doing everything possible to address patient-care issues.
According to a complaint summary provided by the Health Department, an unnamed resident fell Oct. 31, 2004, and told the nurses she was having pains in her hip.
"The resident stated she very much wanted to go to the hospital for evaluation, but the nurse said it was normal to hurt after a fall, that she was just 'scared.'"
The resident received an X-ray the next day, which showed she had a fractured right hip.
Health Department inspections also showed shortcomings with resident care.
An unannounced Medicare/Medicaid standard survey was conducted Nov. 8, 2005, by the Health Department.
The report concluded there were numerous problems with the interaction between residents and nurses, as well as structural and physical problems with the center.
For example, the report states, "Resident #4 was restrained with a lap tray without pre-restraint assessment, a plan of care for the use of the restraint, or a medical symptom for its use."
Following the survey, Brooke instituted a process to evaluate the need for restraint, which is required by the Health Department.
Cottingham pointed out that there have been no substantiated complaints with the nursing home this year.
Management changesCottingham started at the center in January, and said she's worked with the staff to ensure a better quality of living for the residents.
"I came here to make the facility more stable, and it seems to have worked a lot better," she said.
Still, other problems have surfaced at the Brooke center. In June, the Health Department found E. coli contamination in well that provides drinking water to the center.
Kelly Lobanov, spokeswoman for the Health Department, said the nursing home was required to notify the staff and post a "Boil Water Notice."
"If you're going to use the water for consumption, you have to boil it," she said.
Brooke officials posted signs June 29, and decided July 13 to resolve the situation by shock-chlorinating the water.
Denise Henderson of Stafford, whose 99-year-old grandmother lives at Brooke, said relatives should have been notified about the water problem as soon as it was detected.
"When they had the water problem last month, I went to see my grandmother and there was a sign on the door that said they were not in compliance with the water system and it said something about bacteria and E. coli," Henderson said. "And I said to them, 'This is why you should condemn this place.'"
Valerie Hopson-Bell, ombudsman for the Rappahannock Agency on Aging, said she was aware of the water problems, but overall, it seems that things have improved at Brooke this year.
"I have not been receiving as many calls from family members," she said. "There are less people saying they're unhappy."
Hopson-Bell attributed the improved care to the new management and staff. A bookkeeper at Brooke handled the management, but after Cottingham was hired, care improved.
Hopson-Bell said that while things have gotten better, Brooke is an old facility that needs a lot of work.
Repairs requestedA resident who was supposed to remain under supervision did not trigger an alarm when she left the center, according to a 2005 Health Department survey.
Laura Brush said her mother, Anne Wall, wandered into the driveway of the center, where she fell and scraped her head and legs.
"My mother had Alzheimer's and when she wasn't watched, she left. The alarm system was really old and consisted of a buzzer attached with duct tape," Brush said.
According to the complaint Wall filed with the Health Department, another resident's family member found Wall lying on the pavement bleeding from a scrape on her head.
The survey by the Health Department after the incident required the center to check all of its alarm systems, and an extra alarm was added.
Brush said there were other problems.
"There was a broken window in her room for 10 months and we complained about that and there was a faucet that constantly leaked hot water in the bathroom she shared. She would stand there and she had Alzheimer's so she would try and try to turn it off, so we complained about that," she said.
Brush said she was told the nursing home couldn't afford any of the repairs she requested.
"There were always excuses for the problems."
Along with reports from the Health Department and residents' families, the facility is not currently meeting state fire codes.
The state fire marshal has requested that Brooke install a new fire sprinkler system and make multiple other repairs.
Brooke officials asked for more time to make the repairs, until Aug. 1, 2007. The fire marshal's office did recommend that extension to the state Health Department, but there has not yet been an approval or rejection, said Holly Cammarasana of the fire marshal's office.
"Until we hear one way or another, we just go forward as if it's been approved," she said. "We should expect to hear something in a couple of weeks."
The repairs, which are estimated to cost close to $250,000, have not yet been completed.
The center's administration has filed for the extension, saying they plan to resolve the problems with Brooke.
Hopson-Bell said she does not expect the current owner of Brooke to make any of the repairs because they are so expensive. She said it's possible that residents may be displaced if Brooke closes and a new nursing home hasn't yet opened in the county.
Cottingham argues that the center's staff has improved care, but the center ultimately needs to be replaced.
"The facility is so old that it may not even be feasible to fix it," she said. "It's a shame that the age has ruined Brooke."
Cottingham said that if a new nursing home replaces Brooke, she has been promised that the current staff and center residents have first priority in the new facility.
To reach ELLEN BILTZ:
Email: ebiltz@freelancestar.com
