Wednesday, December 17, 2014

Dan Fish

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University Nursing Home in the Bronx is part of a large consortium of rehabilitation and home health companies called Centers Health Care. Credit Edwin J. Torres for The New York Times
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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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