The call from the nursing home came at 5:30 a.m. on July 31: “Your husband, admitted last night for a short rehab stay, has been found not breathing.” The fire department rescue squad entered her husband's room -- two hours after he died -- apparently they were not called until the day-shift supervisor arrived for her shift.
The incident, described in a state report released this week, sent state Health Department investigators to the nursing home, and has added fresh scrutiny to a facility already under special review because of past care infractions.
The Health Department report states that the man was still warm, but not breathing and without a pulse when the rehab unit manager found him. The LPN and her nurse supervisor did not know that the man had orders for resuscitation, so they didn't try to revive him. Even if they had known, the nurses did not know they were supposed to start CPR and call 911 even if no one witnessed his cardiac arrest.
In addition, neither nurse had current CPR certification, neither had been briefed on emergency procedures and neither knew where to find the resuscitation kit -- found during the inspection, but missing some of the equipment.
"Something should have been done instead of calling me," the widow told investigators.
The home neglected the resident by not acting promptly to try to revive him, the department concluded, and was cited for three rule violations connected with the confusion, lack of action and lack of emergency training among key workers.
The home has appealed the allegations of neglect saying that the LPN was fired by the home, and that her comments to investigators were "erroneous and exaggerated." The nurse was properly trained and should have started CPR and called 911 "even though the resident was beyond resuscitation."
The home was placed on a list of homes to be more strictly monitored by the state on March 2. During three inspections since January 2008, the home was cited for 58 violations. (The state average is nine infractions per inspection). Complaint investigations added four more citations, including those from the incident in July. Two of those were in the most-serious category, so it will take two good inspection cycles to get off the list, state officials said. For more, read the story.
Robert W. Carter,
Jr. is a Virginia attorney whose law practice is dedicated to
protecting the rights of the victims of nursing home and assisted
living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg,
Danville, Charlottesville, and across Virginia.
Posted on Tue, December 8, 2009
by Kristie Pierce