Unable
to see clearly and afflicted with dementia, Frank Mercado, 77, depended
completely on the care provided by the small nursing home in the Bronx
where he had lived for four years. But last Monday, as Mr. Mercado cried
for help, a veteran employee beat him to the ground, where he was
impaled on a sharp metal protrusion from an overturned table, according
to prosecutors.
Mr.
Mercado died hours after the beating, and on Monday, the Bronx district
attorney’s office said the employee, Cherrylee Young, 41, had been
charged with negligent homicide, fatal assault and endangering the
welfare of an adult.
The
death, which was ruled a homicide by the medical examiner, underscores
the vulnerability of frail nursing home residents in New York State,
where rates of substandard care, neglect and abuse are high, according
to national studies. Advocates for elderly and disabled residents
complain that state enforcement has dwindled in recent years, even as
private companies have been on a buying spree, acquiring nonprofit
facilities and often cutting staff to enhance profit margins.
The
nursing home, University Nursing Home on Grand Avenue, is small, with
only 46 beds, but it is part of a large consortium of rehabilitation and
home health companies called Centers Health Care.
Kenneth
Rozenberg, the consortium’s chief executive, is an owner or director of
17 nursing homes, including University. It has scored high in federal
rankings, though the integrity of those rankings was called into
question in a recent investigation by The New York Times, and in recent years state officials found numerous violations there.
Thomas
McCartin, a spokesman for Centers Health Care, said Ms. Young, who has
worked at the nursing home for 14 years, had been suspended. A lawyer
for Ms. Young, Jacob Lemon-Strauss, could not be reached for comment.
Mr.
McCartin said University Nursing Home had an exemplary health care
history, including a five-star rating from Medicare.gov. He said the
company was assisting the Police Department in its investigation but
declined to comment further.
Only one-fifth of the country’s 15,000 nursing homes have received the top rating from Medicare,
but The Times this year reported that the ratings rely heavily on
self-reported data from nursing homes that the government does not
verify, and that can be incomplete and misleading. Medicare has since
made changes to its rating system, which will take effect in January.
Over
the last four years, the state has found 19 life safety code
deficiencies at University, compared with a statewide average of 11 over
the same period. A State Health Department inspection in 2011 cited the
nursing home for filthy rooms, for broken equipment — including
over-the-bed meal tables — and for failing to properly report or
investigate resident injuries for possible abuse.
In
one case, an 86-year-old woman’s hand was lacerated on nails sticking
out from a wardrobe; in another, an 81-year-old man with dementia
complained of shoulder pain and then developed large bruises on his arm
that went uninvestigated.
Employees
told state inspectors they did the best they could with the staff
available. At the time, state records show, the home had about 88
percent of its residents on Medicaid and reported a net income of more than $629,000.
From
October 2013 to last June, the nursing home received poor ratings in a
number of care benchmarks: 74 percent of patients had depressive
symptoms, compared with 11.7 percent statewide and 6.2 percent
nationally; 16 percent of residents lost too much weight over the course
of their stay, almost three times the state average and more than twice
the national average; and 4.8 percent had catheters inserted into their
bladders and left there, compared with a state average of 2.6 percent.
Richard
Mollot, executive director of the Long Term Care Community Coalition,
which works to support nursing home residents, said nursing home owners
and administrators always wanted to blame individual employees, which
was a way to ignore the systemic problems.
“When
there’s not enough staff it puts enormous pressure on the staff that
are there, and really a facility has the potential to become a hotbed of
neglect, if not abuse,” Mr. Mollot said. “We see serious problems that
come down to the administration and the ownership, which is ultimately
responsible for the safety of residents.
“This
owner has a reputation of coming into facilities and reducing staff,”
he added, citing press reports since 2010 on some of Mr. Rozenberg’s
acquisitions.
Mr.
McCartin said University Nursing Home was fully staffed with very
dedicated and caring professionals, and had been since it was first
acquired in 2001.
To
Mr. Mollot, the most alarming state statistic is that 45 percent of the
home’s residents were placed on psychotropic drugs there for the first
time, more than double the national average. “This is a marker of poor
care,” he said.
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