South Carolina LPNs Arrested For Not Changing Wound Dressings

Two LPNs in a skilled nursing facility were arrested and charged with a felony for not changing the dressings on two patients. The charges raise more questions than they answer.

Updated:   Published

According to South Carolina Attorney General Alan Wilson's office, two LPNs at Magnolia Manor in South Carolina were accused of failing to tend to the injuries of two residents. They were arrested and charged with Neglect of a Vulnerable Adult on December 8, 2022. 

"A joint investigation between the Spartanburg Police Department and the Medicaid Fraud Control Unit (SCMFCU) found that between September 9th and September 11th, 2022, the two nurses allegedly failed to provide appropriate care as per the medical orders.”

Five months later, still not much is known. Here's what we do know:

  • Both are from South Carolina-the two LPNs are Alyssa Morris, 22, of Cowpens, South Carolina, and Heather Gowan, 44, of Gaffney, in South Carolina
  • Heather Gowan has been licensed as an LPN since 2007, while Alyssa Morris has only been an LPN since February 2022. 
  • The charges claim the nurses both intentionally failed to change wound dressings at the skilled nursing facility, which caused the wounds to "increase in size." This incident was reported to law enforcement by Magnolia Manor, who cooperated fully with investigators.
  • The Attorney General's Office plans to prosecute Morris and Gowan.

Neglect of a Vulnerable Adult in South Carolina

According to South Carolina law,  a vulnerable adult is a person "eighteen years of age or older who has a physical or mental condition which substantially impairs the person from adequately providing for their care or protection. A resident of a facility is a vulnerable adult." 

Consequences

Neglect of a Vulnerable Adult is a felony in South Carolina and, upon conviction, carries a penalty of up to five years in prison.

Who Turned Them In?

According to the news, the facility, Magnolia Manor, reported itself to law enforcement. It's fair to say that healthcare facilities do not turn themselves in; instead, someone files a complaint. So it's conceivable a complaint triggered the investigation.

It also seems that Magnolia did not turn themselves in so much as they turned in the two nurses. Interesting that Magnolia chose to involve law enforcement rather than the BON.

Who notified the authorities?

It could have been a:

  • Disgruntled or concerned coworker
  • Family members (of both families?)
  • Provider

It's doubtful that a provider would have filed a complaint to law enforcement as they would have instead complained to the administration. It's also likely the provider would not have been aware because they do not round frequently in skilled nursing facilities.

A family member may have noticed that the dressing on their loved one was not changed as ordered, but there were two patients. Maybe the families talked amongst themselves and reported.

Perhaps a coworker was concerned for the two patients.

Collecting Evidence

The dates are precise, September 9 and September 11. These are the dates the ordered care was not given. A significantly larger wound would not have been realized in 1-2 days, so were progressive photographs of the wounds taken as evidence? 

What evidence shows that the dressings were not changed during that time? Photographs of an unchanged dressing? Taken by whom?

How does the state prove intention, as in "intentionally failed to change... wound dressings"?

Medicaid Fraud Control

Medicare or Medicaid fraud can take many forms, such as billing for services that were never actually provided, performing tests that are not necessary, and obtaining benefits without being eligible. 

Other types of fraud include:

  • Billing for phantom patients
  • Double billing
  • Billing for non-covered goods or services
  • Billing for more expensive services than were performed
  • Kickbacks

The fact that it's a fraud investigation means it was probably documented but not done. It's possible that multiple wound dressings were billed for but never done. In that case, the facility would be cited. 

Unanswered questions

Anyone who has worked in a hospital or licensed subacute knows the process. A complaint is filed, and there is an investigation. If deficiencies are found, the facility is cited and must then come up with a corrective plan of action. Why was the facility not cited, as is typical in such cases? 

Possible scenario

There's a scenario where the nurses followed the existing culture at the skilled nursing facility and wrongly chose to document tasks not done.

Was documenting care not given common practice at this facility, or were these two LPNs outliers in terms of skipping care? If other nurses could do the ordered dressing changes, then why couldn't they?

Or conversely, if no one could routinely complete their work, why were these two targeted?

Assuming nurses Morris and Gowan documented fraudulently, were they dishonest and intentionally slacking or dishonest and overwhelmed? Did they document the dressings as done, intending to do them later? 

Were nurses provided enough time and supplies to complete their assignments? 

As of today, they both have active compact state licenses. They both face criminal charges, and they'll likely face BON sanctions. 

This writer is looking forward to hearing and sharing more facts about the case. 

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Nurse Beth

About Nurse Beth, MSN

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Hi! Nice to meet you! I especially love helping new nurses. I am currently a nurse writer with a background in Staff Development, Telemetry and ICU.

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Specializes in ER.

It sounds extreme to me to actually arrest someone for having documented, but not completed a task. Were they taken away in handcuffs?

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Specializes in Tele, ICU, Staff Development.
Emergent said:

It sounds extreme to me to actually arrest someone for having documented, but not completed a task. Were they taken away in handcuffs?

It does sound extreme and there must be more to it. I don't know if they were handcuffed, that would have been unnecessary.

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If not much is actually known about this situation, there's no end to how much anyone can speculate about what happened, what the working conditions were, etc.  I'm not sure it's really useful to speculate at this point.  If your concern is that charges have been brought against nurses again and that you don't believe nurses should face charges, period, I think that nurses and other licensed healthcare workers are going to have to come to terms with the fact that they too can face charges.

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Specializes in kids.

Woah,  I'm sure there is more to the story but Wowsa! The thing is, even of they didn't get to it for whatever reason, in report you pass it on for the next shift. Health care is a 24 hour business. But, if they charted that it was done when it wasn't, well, that's on them. 

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Specializes in ER.

It's interesting to me that they would arrest a nurse in this scenario, but when healthcare workers get assaulted in the emergency room, rarely is anything done.

It seems more appropriate that the Board of Nursing should do an investigation on a complaint such as this.

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This is the kind of stuff that is going to drive nurses out of the profession. Why aren't  administrators, managers and owners ever charged for intentional understaffing and poor conditions in their homes? 

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Specializes in Critical Care, LTC.

This is a shame. Nurses working in all levels of care are working with higher patient ratios, higher patient acuity and there is a massive shortage of nurses, globally. It wrong to skip dressing changes and falsely document, but I am sure it happens more times than one would think. 

Whomever had the time to take the pictures should have used that time more wisely and professionally and offered to help the nurses. It certainly sounds like this was reported by another employee. 

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Specializes in Geriatrics.

This is troublesome. Has it come to the point where you, as a healthcare worker, have to additionally prove you're completing tasks outside of the charting? Should we hire someone to follow us with video cameras ? What is this country coming to? I'm seriously frightened as a nurse working in these dangerous times. This is now the second mainstream account of a healthcare institution having workers arrested to cover their own behinds. If these nurses intentionally didn't change a dressing, it's because they thought they could get away with it essentially, most likely due to lack of management and leadership. The institution wants to forego all responsibility and throw the nurses under the bus instead of coming clean about their role in this nonsense. BON should be the authority here, not the police. We need more info on if this was truly intentional, oversight, or overworked staff. I wonder what their nurse to patient ratios are.... I also would like to know if anyone else had difficulty with this wound care or with this patient. Playing devils advocate maybe they felt like it was outside of their scope- who knows? We need more insight into what occurred. The BON could have been instrumental in finding these things out and escalated up to police if there was proven intent to harm/neglect/abuse.

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I am not sure when you last looked into the regulations and oversight of SNF's, but they absolutely do self-report incidents and this would fall under a required reportable. As a former DON of 27 years, I have self-reported multiple incidents under the regulations with my highest rate being 60 reportables in a 3 month period. 

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Specializes in Tele, ICU, Staff Development.
KathrynRNBSN said:

I am not sure when you last looked into the regulations and oversight of SNF's, but they absolutely do self-report incidents and this would fall under a required reportable. As a former DON of 27 years, I have self-reported multiple incidents under the regulations with my highest rate being 60 reportables in a 3 month period. 

With your experience, what do you make of the arrests?

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complaint 2.pdf  The facility was cited (attached) Without actually doing the investigation, which would be extensive, it is difficult to say although I think it's a very slippery slope. 

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