Whistleblower Nurse Vindicated

Nurses General Nursing

Published

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

Originally posted by KristiWhite2377

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

Most probably, this was a PEG feeding tube that was inserted through the abdominal wall for long term feedings. If it is accidentally pulled out, it can be reinserted through the opening left in the stomach wall. This is a common practice in nursing homes, but it must be reinserted carefully. Placement must be checked by aspirating stomach contents to make sure the tube is in the stomach. On occassion, the tube can pass between the abdominal wall and stomach, and instead be placed in the peritoneum. If tube feedings are given without checking for proper placement, they can be instilled into the peritoneum, causing peritonitis. In this case, it sounds as if the feedings were being instilled into the peritoneum for quite some time. I have seen this happen once before, and this lady also died. In a hospital setting, reinsertion of a PEG is usually done by EGD to prevent this kind of thing.

A lot of LTC facilities are very blase about their staff reinserting a G Tube or a cut off foley- balloon apparatus....they think if they aspirate some fluid it must be in the stomach.... this is a dangerous practice, IM0.

I've cared for way too many patients from LTC with major GI complications resulting from this practice: peritonitis, sepsis, abcess, necrotizing fasciitis, even death...due to this practice.

There is too much risk of fistula formation, and I refuse to reinsert pegs myself ...I notify the doc for proper followup. IMO, they should be done under fluoro and/or checked just like we check Dobbhoffs and feeding NG's for proper placement. :o

How long do you think that sort of thing takes to develop?

Feeding tubes pretty much just "drip" don't they?

Right through the peritoneum huh. Sounds kind of easy to figure out, but we shall see.

Ok, if thier abdomen starts swelling and resembles jello something could be wrong.

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