Whistleblower Nurse Vindicated

[fiestynurse]

Beverly facing criminal charges

Nursing home operator also hit with civil complaints

8/1/02

By JOSHUA MOLINA and SCOTT HADLY

NEWS-PRESS STAFF WRITERS

State and local prosecutors have filed criminal and civil complaints against a multibillion-dollar company that ran a local nursing home, the News-Press has learned.

The cases filed Wednesday by the Santa Barbara County District Attorney's Office and state Attorney General's Office come two years after a whistle-blower nurse at Beverly La Cumbre convalescent hospital shot herself in the heart, in despair that no one would listen to her complaints of alleged elder abuse there.

Mary Hochman committed suicide in the gently rolling surf of Tajiguas Beach. Left behind in her station wagon parked nearby was her detailed journal and suicide note -- important clues that helped prosecutors begin what turned into a two-year investigation into the practices of Arkansas-based Beverly Enterprises Inc. and its Santa Barbara facility, Beverly La Cumbre.

With her final act, Mrs. Hochman was able to do something she could not do in life -- shed light on allegations of abuse at the facility where she worked for eight years.

On Wednesday, her husband, Michael Hochman, said the last time he talked to authorities was soon after his wife's death. Upon hearing about the legal action, he said, "I had hoped something would happen."

Her death prompted a series of investigative reports in the News-Press that detailed allegations of abuse at the facility.

On Wednesday, in Santa Barbara County Superior Court, Deputy District Attorney Tracy Grossman, who heads the elder abuse unit, filed a two-count felony criminal complaint against Beverly Enterprises-California Inc.

The cases involve former patients Laura K. Simmons, a 102-year-old former church deaconess who died in July 2000, and William Marthai, an 86-year-old former fighter pilot who died a year later. In addition to the two criminal complaints, authorities filed a civil complaint alleging more than two dozen violations of state and federal public health codes involving patient care, infection control and nursing services, among others.

Beverly Enterprises Inc., in Fort Smith, Ark., did not return News-Press calls on Wednesday.

A hearing on the matter is scheduled this morning in Superior Court. State Attorney General Bill Lockyer plans to make an announcement about the case at noon in Los Angeles.

District Attorney Thomas Sneddon said Wednesday he will hold a press conference on the matter this morning.

It wasn't until the News-Press reported on the deaths -- and on a citation issued by the state against Beverly La Cumbre involving Mr. Marthai -- that authorities became aware of the incidents.

"I think there's something fundamentally wrong when prosecutors and law enforcement find out about this in the newspaper," Ms. Grossman told the News-Press last December.

Though her death certificate stated she died from congestive heart failure and extremely high blood pressure, Ms. Simmons suffered from malnutrition, anorexia, bed sores, body tremors, open wounds and a maggot infestation of her foot at the time of her death.

Friends recalled her as vibrant, energetic and smart, a woman who enjoyed walking and taking the bus to do her shopping up until the age of 99.

Mr. Marthai died after a feeding tube was incorrectly inserted into his stomach by a vocational nurse. When he was finally taken to the hospital, his face was pale and his stomach had swelled to the size of someone who was seven or eight months' pregnant. It was as hard as a rock.

"I can't breathe. I think I'm going to die," he reportedly told a nurse.

Mr. Marthai's death certificate listed peritonitis with septic shock -- infection of the abdominal cavity with blood poisoning -- and gastrostomy tube dysfunction as the causes of death.

The state Department of Health Services, which oversees nursing facilities, determined that the Beverly La Cumbre nursing staff failed to check whether the feeding tube was inserted and working properly. As a result, the state issued Beverly La Cumbre a AA citation, the harshest penalty a nursing home can face.

On Wednesday, Mr. Marthai's daughter, Nancy Parsons -- now an advocate for seniors in nursing homes -- said she hopes something good will come out of the criminal filing.

"Unless the DA, unless everyone else involved who is suing on behalf of my father, were able to take such an absolutely huge amount of money, or status, or credibility, from them, it will be business as usual, because it is easier for them to ignore the elders than to give them the respect that they have earned," Ms. Parsons said.

Prescott Cole, of California Advocates for Nursing Home Reform, welcomed the cases.

"This is very rare," he said. "The Santa Barbara District Attorney's office is courageous for dedicating the resources for something like this. It's extremely difficult to go after a facility like this. It's difficult to prove neglect and abuse."

The cases also bring up the difficulty of policing nursing homes, Mr. Cole said. The Department of Health Services tends to be understaffed and unsupported, he said.

Deaths at nursing homes are seldom investigated and cooperation between the Department of Health Services, the local District Attorney and the Attorney General's office is woefully lacking, Mr. Cole said.

Mrs. Hochman's death was the first incident in a series of problems for the company and its corporate owners. Citations followed, a Beverly home was shut down, a flurry of civil lawsuits were filed, and eventually Beverly transferred operation of the home to Helping Hands Sanctuary of Idaho.

The home, at 3880 Via Lucero, has since been renamed La Cumbre Senior Living Concepts, as workers and management try to wipe away the memory of the Beverly name.

In her suicide note, Mrs. Hochman detailed her own frustration with the Department of Health Services. Only a week after first blowing the whistle on alleged abuse at the facility, her boss called to berate her and asked her what she was complaining about, her husband said.

The note said she had lost her faith in nursing and that she could no longer watch her husband and daughter suffer, because she was the primary breadwinner.

"Since I became a whistle-blower my entire life has been ruined. I tried to do the right thing to protect my patients ... If a nurse cannot protect her patients I do not want to be a nurse. This has taken all hope away from me," she wrote.

Aug. 31, 2000: Mary Hochman, a nurse for eight years at Beverly La Cumbre convalescent hospital, shoots herself in the heart at the beach. She leaves behind a suicide note and a journal alleging abuse and neglect of elderly patients at the facility.

September 2000: The state Department of Justice, office of the Attorney General Bureau of Medi-Cal Fraud, opens a criminal investigation into Beverly La Cumbre, at 3880 Via Lucero in Santa Barbara.

Sept. 24, 2000: A News-Press front-page investigative report, "In Need of Care," tells Ms. Hochman's story and details Beverly La Cumbre's pattern of patient care problems earlier that year.

Sept. 26, 2000: The first in a series of civil lawsuits against Beverly La Cumbre is filed by the family of a 93-year-old patient whose leg was amputated below the knee after she developed gangrene.

October 2000: Public documents show that state investigators cited Beverly La Cumbre for neglect twice -- once in September and again in October. Along with the citations, investigators found that the nursing home failed to do required background checks on 11 of its certified nursing assistants.

October 2000: In response to a nursing shortage and increased scrutiny over allegations of elder abuse at Beverly La Cumbre, corporate officials announce plans to close Beverly Manor (its smaller sister facility in Santa Barbara) and relocate residents to Beverly La Cumbre. Beverly Manor shuts down soon after.

November 2000: Another state review of Beverly La Cumbre finds nearly 25 instances of neglect during a two-week unannounced investigation, and the hospital's plan for correcting those problems is rejected by health authorities.

December 2000: Beverly La Cumbre is notified that government funding would be denied for all patients admitted to the facility after Dec. 21, 2000, because the facility is still not meeting state standards for minimum care. The state Department of Health Services also notifies the facility that April 16, 2001, is the cutoff date for all Medicare and Medi-Cal funding unless all problems are fixed.

January 2001: The state Department of Health Services issues 25 citations for the abrupt transfer of 30 elderly residents from Beverly Manor to Beverly La Cumbre in October. The citations carry a fine of $500 to $1,000 each.

January 2001: Beverly La Cumbre is cited by the state Department of Health Services for admitting patients at a time when facility officials knew they lacked the proper level of nursing staff to care for them.

January 2001: Special agents from the state Department of Justice seize hundreds of documents and electronic files from Beverly La Cumbre, searching for evidence of criminal abuse, neglect and Medi-Cal fraud at the embattled convalescent hospital. Agents also serve a search warrant at the Los Angeles home of Sharon Karoshec, a regional vice president for Beverly Enterprises Inc.

April 2001: Beverly La Cumbre passes a state Department of Health Services inspection that finds the convalescent hospital is meeting minimum standards for care.

July 2001: Beverly Enterprises' corporate spokesman confirms that the company is in talks with various parties to take over operations of Beverly La Cumbre and Beverly Manor.

Nov. 1, 2001: Helping Hands Sanctuary of Idaho takes over operations of Beverly La Cumbre and renames it La Cumbre Senior Living Concepts.

http://news.newspress.com/topsports/080102beverly.htm?now=67464&tref=1

[hoolahan, ASN, RN]

This is too sad. I mean I am glad that the facility is being charged, but why would she choose to take her own life over her job and leave her poor family behind. To make that decision, she must have been in deep deep pain, and all I can say is what a great loss.

[Brownms46]

[Rustyhammer]

Sounds like there may have been other issues leading up to her suicide.

I can CERTAINLY understand the frustrations that go along with nursing and coorporate health care but I can't see ending it all solely because of it.

-Russell

[flowerchild]

Russell, my husband said the exact same thing.

[fiestynurse]

Lessons to be learned:

1) Before taking any irrevocable steps, talk to your family and close friends about your desire to blow the whistle. The stress of exposing your employer's alleged wrongdoing - and the possible fallout in terms of harassment or termination - often causes substantial family problems. The entire family will suffer any resulting hardships. Some whistleblowers actually receive death threats or threats to their family.

2) Beware - sounding the alarm internally may trigger a coverup. If you disclose your concerns to company officials who are engaged in the alleged wrongdoing - especially serious misconduct - it may give them time to destroy evidence you will need to substantiate your claims in an investigation. Mary had evidence that records were destroyed.

3) People will question your motives and try to destroy your credibility and reputation. They will try to make you look crazy and many times you will feel like you are going crazy. Co-workers, who you thought were your friends will abandon you. Suicide is not rare amoung whistleblowers. Mary was a whistleblower for purely altruistic reasons and did not have other "issues."

4) Develop a detailed record. Before and after you blow the whistle, it is critical that you keep a careful record of events as they unfold. Keeping sketchy or sporadic records of the activities in question, and any purported harassment, is one of the most common mistakes that whistleblowers make. The time you spend now to carefully document pertinent developments could be very valuable in any investigation or court proceedings. There are several good ways to do this: Keep a diary, such as Mary did. Any factual log of your work activities and what is happening around your workplace should be as straightforward as possible. Focus on the alleged wrongdoing and on your disclosure, and stick to the facts. Leave out speculation, personal opinion or animosity you may have toward the situation, your co-workers or management. Each entry should be dated and initialed by you.

This is a critical investment in maintaining your credibility during the disclosure. Mary's diary, that she left behind after her suicide, was key information that lead to the filing of criminal charges against the nursing home.

5) Pinpoint and copy key records. You should identify and copy all necessary supporting records before drawing any suspicions to your objections. Once your accusations of potential abuse or fraud become known, you may be perceived as a threat to the organization, and your access to sensitive data or information may be cut off. It is very hard to wage a successful campaign against any wrongdoers without credible documentation to back up your claims. You must have enough evidence to give authorities probable cause to pursue an investigation.

6) Create a large support circle. Successful whistleblowers are those who have communicated their message to the largest number of citizens who stand to benefit from the exposure. This is where Mary failed. Nurses are not very good at taking care of themselves. She should have sought out support and gone to the local newspapers with her story. It helps to contact an organization of professionals that specializes in assisting whistleblowers. These groups can play an invaluable brokering role, in terms of helping you to channel your sensitive information to the best outlets, while minimizing the impact of personal or professional fallout. Single-issue or conventional public-interest groups, on the other hand, may use your information to advance their own agenda, instead of helping you to deal with the consequences of your actions.

7) Encourage stronger whistleblower laws to protect nurses from unjust penalty or dismissal. Blowing the whistle is a high-stakes game. But, by exposing fraudulent or unsafe practices in the health care industry, you can affect powerful change. The well-armed whistleblower has an organized plan and a keen knowledge of existing employee-protection laws. Despite any warnings or threats you receive, the right to blow the whistle - and to be protected in doing so - is the cornerstone of a free society.

I don't approve of what Mary did, but she will always be my hero.

It takes an incredible amount of courage to take a stand and blow the whistle. Life can get complicated when a worker decides to go one-on-one with an employer

[NICU_Nurse, BSN, RN]

Forgive my lack of knowledge here, but could someone explain exactly how the feeding tube could have been incorrectly inserted and causes that man's discomfort and abdominal distention? I think my brain's on vacation. ;>P

[betts]

Read my post; https://allnurses.com/forums/showthread.php?s=&threadid=16925

[fiestynurse]

I also forgot to mention that Beverly Enterprises settled with Mary Hochman's family early on for an undisclosed amount.

[Ex130Load]

Beverly's problems and condition were probably observed by others. Where were they when she needed them, especially any that called her a friend? Many times, concerned friends can make a difference and help prevent tragic departures like hers.

I keep reading throughout the many discussions/topics in this web site how we nurses (student and otherwise) need to stick together and help each other.

Her loss is tragic and possibly could have been prevented. My point, we need to look out for each other's welfare. I may not like you, but at the human being level I don't want to see you kill yourself needlessly. There are options, alternatives, and help available.

[mattsmom81]

This poor woman....I wish she would have sought help for her worsening obsession of what she saw as elder abuse...we have to know how to not let this stuff eat at us this way or we can truly drive ourselves crazy.

Thanks for the link...I'll follow up.

Feistynurse, thanks for your whistleblower info...so true how when we 'make waves' in the community with allegations of unsafe conditions, our families will likely suffer, and our own mental health will suffer. Nurses may keep their license, but be unenployable due to area blackballing...and I've seen this happen when they speak up and fail to work carefully within the system to effect change. Did you see this happen to a friend or coworker of yours?

How sad this poor woman had to die...I wonder if she was suicidal in nature prior to this...undiagnosed...and decided to use her death for a 'good purpose.' in her mind. So very sad.

We're in a tough spot today, we nurses.

[Peeps Mcarthur]

By Kristi

Forgive my lack of knowledge here, but could someone explain exactly how the feeding tube could have been incorrectly inserted and causes that man's discomfort and abdominal distention?

I haven't had any clinicals yet but I would imagine that the tube either went through a fistula and drained into the peritoneum or that it blocked the pyloric valve. I think it was to much volume to be just in his stomach.

Or perhapse a combination.

Since the pyloric valve is opend by the pressure of the contents of the stomach it would have to be only partially blocked. A fistula could occur with the use of an NG tube(or any other tube) over time and therefore would be in the common path of the "wrongly" placed tube.

This is an example of someone who never sought out psych help for whatever reason. I echo the sentiments of other posters that say we should be looking out for eachother and help direct someone to help when it's apparent to everyone but them that they should seek conseling.

It's so sad that no one bothered to take action except for that courageous nurse. They wouldn't do anything until it made them all look bad that she killed herself.

Remember, if you blow the whistle on your employer you must be prepared both on paper and personaly to push the issue to the goal that you set in first doing it. You must find thier "hot button" (usually the media) in order to motivate heartless automatons of government office.