RSSNursing home cited
Facility didn't follow doctor's orders for man who later diedYakima Herald-Republic
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UNION GAP -- Parkside Nursing Care Center, which has a recent history of serious problems with regulators, was cited Tuesday for failing to follow physician orders in caring for an elderly man who suffered from bedsores.
The patient died last month at Yakima Valley Memorial Hospital from an infection, but state authorities couldn't find evidence of a link between his care at the nursing home and his death.
The problem came to the attention of the state after hospital personnel removed the patient's dressing on a heel wound and found maggots.
It's only the latest trouble for Parkside, which had 28 deficiencies between January 2007 and the end of March 2008, nearly triple the statewide average of 10, according to Medicare. State officials described the problems as "systemic," and said Parkside's reimbursement from Medicare could be in jeopardy.
"We have been working with them but they have received more citations than usual," said David Moon, regional administrator of residential care services within the state Department of Social and Health Services. Moon is based in Yakima.
Jeff Marshall, chief executive of Eagle Healthcare in Kirkland, Wash., which owns Parkside, said the nursing home has had "leadership problems," including turnover in the top two positions -- administrator and director of nursing services.
A new Eagle-trained administrator has been hired and the state has supplied a "quality assurance" nurse to temporarily fill the position of director of nursing services.
"Without good leadership at the top, it becomes difficult to provide quality of customer service as well as care. We think we now have it under control," Marshall said.
The most serious finding occurred in January, when state officials found that many residents were in immediate jeopardy because the nursing home was deficient in "policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property."
More specifically, intruders had entered the nursing home one evening and the staff didn't know how to lock the doors. Police were called to round up the intruders. No residents were harmed, according to Moon, and Parkside subsequently trained the staff to lock the doors at 7 p.m.
While bedsores are a relatively common occurrence at nursing homes, the state found that Parkside caused harm to Gerald Gipson, 72, by belatedly changing a dressing on one of several wounds and applying a different medication than the doctor had recommended, using an unauthorized substitute instead.
But authorities say there is no evidence that the maggots appeared during Gipson's stay at Parkside because he spent nearly two days at home with his family before being taken to Memorial.
"We didn't determine that the maggots originated from the facility," said Moon.
Maggots can be born alive and grow within eight hours, Moon said.
Gipson arrived at the facility with five bedsores, according to state records, and developed two at the nursing home. The heel wound increased in diameter and depth, and dead tissue continued to form around the opening.
Gipson, who was in frail health, was discharged to his family on May 27. On May 29, he was taken to the emergency room, where the wound in question "was noted to cover the entire heel and was very large, moist and deep," according to state documents.
Gipson died May 30.
The citation was a level "G" on a scale of "A" to "L," which Moon said means harm to the patient has occurred or is likely to occur.
Marshall said there was a "slight deterioration" in the problem bedsore while Gipson was a resident. "We're not happy with it. It was a mistake and we've corrected it," Marshall said.
Staff received additional training in caring for and dressing bedsores, he said. No one was disciplined, he said.
Gipson's family has hired Yakima lawyer William Pickett to investigate the circumstances surrounding the death.
"They want answers," Pickett said of the family. "And my job is to get them."
Marshall said the answer is already clear.
"I vehemently deny any connection between our care, the maggots and his death. The state is not making that connection. The police didn't make it," he said.
Union Gap police assisted with the state's investigation, which was completed Tuesday.
Parkside is one of 11 residential care facilities in the state owned by Eagle, including Hillcrest Manor in Sunnyside and Grandview Health Care.
Hillcrest has received perfect inspection surveys five out of the past six years from DSHS. Grandview Health Care received one citation on this year's state inspection.
* Mark Morey of the Yakima Herald-Republic contributed to this report.
* Leah Beth Ward can be reached at 577-7626 or lward@yakimaherald.com.
