LM was just one nursing home patient, but what prosecutors said happened to him is no doubt the nightmare that many adults fear for their aging parents living in nursing homes.
He was suffering from Huntington’s chorea, a neurological disease that left him bedridden. The nursing home resident – identified by prosecutors only by his initials – was totally dependent on the nursing staff at HighPointe on Michigan Avenue, the Buffalo nursing home where he lived.
But both nurses and nursing aides ignored their responsibilities for his care and needs. On a number of occasions, nurses failed to dispense pain medication and check on him. Aides failed to give him liquids and perform incontinent care. And then they falsified documents to conceal their neglect, authorities said.
Those are the allegations that surfaced in a Buffalo city courtroom Friday, where 17 employees of the Kaleida Health facility – one registered nurse, seven licensed practical nurses and nine certified nurse aides – were arraigned on felony charges in connection with the 56-year-old nursing home resident’s care.
The prosecutors found their evidence in the footage from a hidden camera, they said.
“The biggest thing to be aware of is if you have a loved one in a nursing home, be vigilant about their care,” said Thomas M. Schleif, special assistant attorney general in the state’s Medicaid Fraud Control Unit.
“Nursing home residents are among our state’s most vulnerable citizens, and the perpetual neglect in this case is shameful,” Attorney General Eric T. Schneiderman said in a statement.
The multiple-employee charges make this nursing home investigation, which occurred in June 2013, the largest in recent memory in Western New York.
The case surrounding LM, who has since died, reveals the sort of persistent problems found in some facilities, experts say. State authorities have undertaken similar investigations elsewhere in the state this year, leading to other multiple-employee charges.
“These cases get to the fact that something is wrong with the system,” said Richard Mollot, executive director of the Long Term Care Community Coalition in Manhattan.
Quality issues at long-term-care facilities, Mollot said, reflect conditions in a business in which inadequate staffing and supervision occur too often.
“Residents are being failed by the people monitoring them. But, also, in many instances, conditions in nursing homes make it hard to do your job. Employees can be undermined from the top,” he said.
The state Health Department conducted 59 on-site inspections at HighPointe through February of this year. State data shows that the facility’s 6.4 deficiency citations per 100 occupied beds exceeded the statewide average of 2.2. Eleven of the 17 citations dealt with quality of care.
“Seventeen people charged, and that level of citations the last few years. It’s not good,” Mollot said.
He described the investigations by the Attorney General’s Office as “encouraging.” The state has not been aggressive enough in recent years in finding problems in poorly performing nursing homes.
Investigators noted there was no allegation of inadequate staffing at HighPointe. Mollot and others, however, said insufficient staffing is often the key contributor to quality problems at nursing homes.
“These cases show that we need decent staffing standards in facilities,” said Mollot, whose group supports a controversial law for minimum nursing home staffing standards in New York.
A state Department of Health spokesman said the department is aware of the HighPointe situation and is taking appropriate action.
“An impossible job”
Some of the attorneys representing the defendants and others who crowded into City Court Judge Amy C. Martoche’s courtroom Friday afternoon for the arraignments cited heavy workloads and questioned the allegations.
“We are going to visit the Attorney General’s Office next week and view what’s on this nanny camera,” said attorney Paul J. Cambria Jr., who represents Cynthia Kozlowski, a 60-year-old licensed practical nurse from Getzville. “She emphatically denies any wrong doing.”
Attorney Charles J. Marchese said his client, 35-year-old certified nurse aide Nicole Baker, has worked for Kaleida Health for a decade. To his knowledge, she has never had any disciplinary charges brought against her.
“When she works an eight-hour shift, she cares for up to 20 patients,” Marchese said. “She’s a caring person and does everything she’s told to do. She’s the mother of two children.”
One of those charged, Natalie Galbo, 30, of Amherst, is a registered nurse. Seven are licensed practical nurses: Shateeka Stevens, 39, of Cheektowaga; Michael Howell, 40, Buffalo; Heidi Bowens, 41, Buffalo; Rochelle McNeair-Tisdale, 55, Buffalo; Jamie Cunningham, 26, Buffalo; Cynthia Kozlowski, 60, Getzville; and Marlene Sims, 58, Cheektowaga.
The nine nursing assistants charged are Rubetta Harrell, 54, of Cheektowaga; Nicole Baker, 35, Buffalo; Tiffany Heard-Williams, 35, Buffalo; Ruteasha McCray, 35, Buffalo; Kenissa Henderson, 27, Buffalo; Mariah Robinson, 20, Buffalo; Margaret Glass, 23, Buffalo; Amanda Stuart, 34, Sloan; and Hazell Clegatt, 43, Buffalo.
Sixteen of the defendants were arraigned and released on their own recognizance. Their felony hearings are scheduled for different times next month on charges of falsifying business records, endangering the welfare of an incompetent or physically disabled person and willful violation of state health laws governing the care of patients. The last of the 17 is out of state and expected to be arraigned next week.
Family members and friends surrounded many of the defendants leaving the courtroom. The father of one defendant told The News that the workers are often asked to carry out workloads that are unreasonable, given the needs of the patients.
“There’s a patient at that facility who wants 24-hour care and then others end up getting kind of neglected,” the father said, declining to give his name. “It is an impossible job.”
Installing a camera
When told of the father’s observations, Schleif said not all patients demand the same level of attention.
“Our case involved a man who required around-the-clock treatment, but some patients are not as needy,” the assistant attorney general said.
The Attorney General’s Office investigates nursing home complaints. “We’re trying to be everywhere at once, trying to watch over the care of patients,” Schleif said.
The camera, he said, was installed without Kaleida Health’s knowledge last June. Schleif said the man’s death did not occur as the result of inadequate care at HighPointe. There are no plans to charge administrators at the facility, he said.
Kaleida officials issued a statement Thursday stating that when they were made aware of the investigation, they took action and fired the workers and also cooperated with the Attorney General’s Office.
“This behavior, and lack of appropriate care, is unacceptable and will not be tolerated,” Kaleida spokesman Michael P. Hughes said in a statement. “Safe and reliable care must be at the core of what we do.”
Eula Nailor, who learned of the case Thursday night, showed up at the courtroom Friday. She said he had a special interest in observing what happened. Her mother, Radie C. Nailor, had been a rehabilitative patient at HighPointe before her March 20 death at Buffalo General Medical Center.
“HighPointe might be a state-of-art facility, but the care is not state-of-the-art,” Nailor said. “My mother was not getting enough fluids to flush out her diseased kidneys and she dehydrated. They doped her up and she started to hallucinate. She went into palliative care and died at Buffalo General. But why would she have been sent to rehab in the first place if she had been dying.”
Nailor was not the only observer.
The family of LM was in the courtroom. They left without making a public statement.
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