Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, September 5, 1993 TAG: 9309050226
SECTION: VIRGINIA PAGE: B1 EDITION: METRO
SOURCE: CAROLYN CLICK STAFF WRITER
DATELINE: LENGTH: Medium
"There was no ambu bag, no ventilator, no suction machine and no oxygen," said the former employee, who asked not to be identified. "There was no kind of sterile procedures. I might as well have had the man in the George Washington National Forest."
The ambu bag, used in resuscitation, was found, dirty, on another unit of the nursing home, the former employee said. The key to the oxygen was found hanging behind a clipboard.
Pamela Cox, a certified nursing assistant who left Avante in June, said she quit because she believed there were suspicious circumstances surrounding the death of an elderly resident in May.
Cox and two former employees confirmed they were questioned by Roanoke police about a dose of morphine administered to the patient shortly before she died. No charges were filed.
Interviews with current and former employees suggest those incidents and others led to a growing number of complaints against Avante and prompted a state probe.
Their opinions mirror the findings of a state inspection team, which conducted a surprise inspection in late July.
Those findings "raised questions regarding the facility's ability to provide adequate care and services and the ability to maintain a safe environment for patients over a sustained period of time," Deborah Spurlock, director of the state health department's Office of Health Facilities Regulation, said in a letter to Administrator Bruce Wood.
Former employees paint a picture of a facility under stress and declining in quality. Some said they feared loss of their state licenses because of shoddy procedures within the facility, and they faulted the director of nursing for creating a climate of fear and intimidation.
Minimum staffing levels meant nurses and their assistants worked against the clock to dress and feed patients, administer proper medications, change bed linens and turn patients to prevent bedsores during a standard eight-hour shift.
Routine supplies - gauze and strips for bandages, diapers for incontinent patients - often were in short supply. Sometimes, nurses said, they had to go to the laundry to wash sheets because there were none available on the shelves.
As workers quit in frustration, the remaining nurses and assistants had to shoulder more and more duties. Replacement workers were hired too quickly to ensure careful check of references and skills.
The result, they said, was that patients were neglected and denied the kind of dignity and respect that compassion - and federal and state regulations - require.
"I could see a difference in the patients," said Cox, who worked at the facility for 2 1/2 years. "It hurts me that all of the patients have to suffer because of someone's negligence."
A licensed practical nurse who worked at the facility said a ratio of two nursing assistants to 40 patients - a ratio they say was established by the nursing home's Florida owners - is not enough to ensure that patients are well cared for.
"They get the best care that they can get with the number of people they have," she said.
Avante Group Inc., of Hollywood, Fla., did not return telephone calls. Wood, the administrator of Avante at Roanoke, spoke to the newspaper after the state investigation was made public, but he did not respond to further telephone inquiries.
During that interview, Wood described the deficiencies cited by the state as involving record-keeping and operational procedures.
"Direct care has not been jeopardized," Wood said.
But a Roanoke woman said she removed her mother from Avante late last summer after the staff left the ailing 87-year-old woman restrained in a wheelchair all night.
The woman said she checked on her mother every day. Several days before the incident, she noticed her mother's complexion was clammy and asked if the staff had contacted her doctor. Over two days, that call was never made.
The staff later justified the decision to leave her mother in the wheelchair overnight by saying she did not want to go to bed.
"When I found out she was in a wheelchair all night, I could not believe it," the daughter said. "My conclusion was they hired people that really weren't trained."
Her mother was hospitalized and later moved to another Roanoke nursing home, where she died in November.
"There was no comparison between the two," the woman said.
by CNB