Disclaimer:- The material is selective
and not all inclusive. The extracts do not necessarily reflect the
perspective of the original. Corporate denials and explanations have
not been included. No claim is made that all of the matters referred
to are true. The intention is to give the flavour of the material and
an idea of the extent of the allegations. Can there be so much smoke
without a large fire? This is a matter of public welfare and the
interests of the pubic must be placed before those of the
Introduction to this www page
The Mount Carmel case is an excellent study of the consequences of board room decisions for care, of the arrogance of a still wealthy company which had the money to address the nursing problems but did not do so, of the use of the law to protect corporate interests, of the anguish for patients and relatives when regulators act and of the continued intransigence of the corporations. It is also important because it suggests a solution - find a reputable and humane not-for-profit group and hand the corporate homes over to them.
Mount Carmel was one of the largest of nursing homes in the USA and so more difficult to manage. In spite of this it had a long tradition of excellent care and the staff were respected and highly motivated. All this changed dramatically when Vencor bought the home. Vencor went into corporate conflict mode and forced staff into a universal corporate contract together with its other facilities. Their standing, their salaries and their perks were all downsized. Morale was destroyed and staff walked. What followed is described in these extracts.
In death, man puts face on Mount Carmel's
crisis Popular longtime resident spent 60 hours succumbing to an
infection; state says he was given deficient care
Milwaukee Journal Sentinel October 11, 1998
Comment:- Donald Garrison was a patient at Mount Carmel when it was bought by Vencor. He blew the whistle by phoning authorities to tell them what had happened there. This article suggests that he died from the same neglect and poor care which he reported. Once again it is a whistle blower and not regulators who expose problems. They often have to go public to do so.
That's when longtime resident Donald Garrison died three days after getting what the state saw as inattentive and sloppy care while he deteriorated badly over 60 hours from an infection.
At the time, Garrison, 44, was living in the 650-bed home's understaffed Spruce Court unit. Over several chaotic days and nights that week, state inspectors found widespread health threats related to the home's dangerously thin staffing.
In the July 16 report, the st ate alleges that Garrison suffered from a delay in getting to Mount Carmel's in-house hospital, a delay in notifying a doctor of temperature changes, and lax nursing follow-up over more than two days.
Just six weeks before he died, Garrison had used his room phone to alert authorities to neglected unit mates, said Jean Trimble, a ombudsman with the State Board on Aging.
"It's fine when the state (inspector) is here, and then they reduce staff as soon as they leave," Ga rrison reported in June.
Turn up heat on nursing homes
Milwaukee Journal Sentinel October 15, 1998
Last spring, the state Legislature passed tough new legislation to regulate nursing homes that do a poor job o f caring for their patients. The horrible problems at Mount Carmel Health and Rehabilitation Center in Greenfield, detailed in a two-part series this week in the Journal Sentinel, show that the state's job is far from over.
Once regarded as one of the better nursing homes in the state, Mount Carmel is now in big trouble with state and federal regulators who believe patient care has been compromised almost to the breaking point at the sprawling 650-bed complex. The home faces a $430,000 federal fine, a sum unprecedented in Wisconsin, and the potential loss of government funding.
One of the worst indictments may be the death of longtime resident Donald Garrison, 44, a live wire who, ironically, had complained only weeks befo re his death that fellow residents were being neglected. Garrison died of an infection in July, three days after getting what the state contends was inattentive and sloppy care, a judgment that the home's operator, Kentucky-based Vencor Inc., disputes.
Vencor's attempt to standardize benefits at its facilities nationwide led to a mass e xodus of staff at Mount Carmel, creating a void the nursing home was unable to fill.
The resulting shortage forced the remaining nurses and other staff to handle an intolerable caseload. Vencor's bottom-line decision to standardize benefits, typical of too many national for-profit corporations in this business, dramatically illustrates the human risk of applying a one-size-fits-all mentality to health care.
DA looking into Mount Carmel case County
joins state in probe of alleged patient neglect at Greenfield nursing
Milwaukee Journal Sentinel October 15, 1998
The Milwaukee County district attorney's office has opened a preliminary criminal investigation into allegations of patient neglect at the Mount Carmel nursing home in Greenfield.
Investigators will review state inspection reports with a focus on any deaths that might be linked to poor care, including the death of Donald Garrison, on July 17, District Attorney E. Michael McCann said Wednesday.
McCann would not comment on whether severe understaffing at the 650-bed home on Layton Ave. could play a role in any potential criminal prosecution.
The home's staffing level was so low this summer that state officials declared that residents were in "immediate jeopard y" of suffering serious harm or death.
Employees and union officials blame benefit cuts and other changes at the facility owned by Kentucky-based Vencor Inc. for much of the staffing crisis. Vencor officials dismiss that accusation, saying t hat a statewide shortage of nursing assistants was the major culprit.
Federal regulators have levied fines of more than $430,000 a state record and blocked Mount Carmel from taking new residents under the Medicaid and Medicare programs.
Loss of federal reimbursements would be a major blow for the home because Medicaid and Medicare make up the bulk of Mount Carmel's budget. The home's 517 residents include very few private-pay clients.
Bottom line hurt Mount Carmel
Milwaukee Journal Sentinel October 18, 1998
As a former employee of Mount Carmel nursing home, I can tell you where it went wrong Vencor.
I knew when Vencor took over and started making changes that I better find a new job. I didn't care for Vencor's b usiness tactics. Vencor is a money-grubbing corporation that doesn't care about residents or employees. Vencor just wants the almighty dollar.
State revoking license of largest nursing
Associated Press October 20, 1998
State officials acted Monday to shut down Wisconsin's largest nursing home over alleged rule violations, giving it four months to relocate 504 residents.
Operators of Mount Carmel Health and Rehabilitation Center in suburban Greenfield, owned by Kentucky-based Vencor Inc., said they planned to appeal the license revocation and order to close Feb. 13.
The state has monitored care at Mount Carmel daily for months. Federal regulators have levied fines of more than $ 430,000 - a state record - and blocked Mount Carmel from taking new residents under Medicaid and Medicare programs.
"Residents were leaving the building. Alarm systems were not in place," Judy Fryback, of the state Department of Health and Human Services, said Monday. "They did not have systems in place to keep track of residents who were disoriented."
The license revocation came after the discovery of 21 new care violations in an inspection last week.
"Those are directly threatening and also have the possibility of death or serious mental or physical harm," Fryback said.
Garrison, 44, died several days after getting what state inspectors said was inattentive and sloppy care for an infection that left him feverish and lethargic. His request for hospitalization was turned down until his condition had badly deteriorated, the state alleged.
State shutting down Mount Carmel: Nursing
home gets 4 months to move patients
Milwaukee Journal Sentinel October 20, 1998
Immediately after Monday's announcement, the home's Kentucky-based owner, Vencor Inc., vowed to take quick legal action to try to preven t any forced moves from one of the nation's largest nursing homes. Vencor said it would fight the loss of Medicare and Medicaid financing in federal court.
But state and federal agencies just as quickly made clear they were not bluffing , with each saying their moves were not even a close call considering the number of serious problems that remain.
"There is absolutely no reason to put the residents through this trauma of a forced relocation," Vencor spokeswoman Susan Moss said. "Transfer trauma is devasta ting to a patient."
"We would try to meet with families as soon as possible," said Cl audia Stine, director of ombudsman services for the state Board on Aging. Legal representatives and attending physicians must also be notified of the relocation plan.
Vencor will soon seek a restraining order to stop the funding cutoff, and if need be it will sue over the license action, Moss said. There is precedent in other states for such a move, she said.
Vencor has drawn lawsuits and tough regulatory action in several states this year over patient care, ejection of Medicaid-supported patients and other issues.
The situation was so serious that the state began daily monitoring of care at the home. That will continue, Rowe said.
Union officials and others have blamed Vencor's insistence on a contract that cut benefits for fuel ing the departures of nursing staff.
Whats next: The home's for-profit owner, Kentucky-based Vencor Inc., is expected to file a federal lawsuit to attempt to block the regulator's moves.
Inspectors still found abundant problems
Concerns last week ranged from bedsores to fluids; state, nursing
home prepare for long legal battle
Milwaukee Journal Sentinel October 21, 1998
COMMENT:- Note from these articles that the corporate response has consistently been to deny, to blame someone else, to litigate, and to make the job of regulators as difficult as possible. This is to be expected as they have a fiduciary duty to protect the financial interests of their shareholders, rather than their patients.
In the end, neither sky-high nurse aide staffing levels nor an expensive face-lift could dig Mount Carmel nursing home out its very deep hole quickly enough.
A resident who missed 22 daily doses of anti-depressants.
A 98-year-old woman with unrelieved pain and bedsores, who complained of a skin burn due to bleach in her blanket. The ski n problem prevented her from moving and from getting services she needed.
Poor response to cases of weight loss and insufficient fluids.
Multiple cases of neglecting to reposition residents at risk of getting bedsores.
Lapses in staff knowledge of how to monitor residents at risk of falling.
A half-dozen residents not given appropriate assistance with eating.
Poor grooming and hygiene among some residents who need basic living help.
A pattern of not giving people "range of motion" therapy.
As reality sank in Tuesday, stunned families and friends of some of the home's 504 residents rose to the defense of Mount Carmel Health and Rehabilitation Center, on Layton Ave. i n Greenfield.
The home's owners had sought an injunct ion to stop a funding cutoff. The judge responded by ordering state officials to put a temporary manager in charge of the facility in hopes of improving care.
Trauma, admission hurdles may await Mount
Milwaukee Journal Sentinel October 22, 1998
The 504 residents of Mount Carmel Health and Re habilitation Center face closed nursing home doors, increased disability and perhaps, in a few cases, even death if they eventually are forced to relocate under this week's state mandate.
Although advocates for the elderly and disabled backed the state's revocation of the nursing home's license, concerns were raised Wednesday about the eventual fate of the residents if they are forced to move.
"My major concern right now is that some area nursing homes will deny admission to patients solely because they are on Medicaid," said Rep. Peggy Krusick (D-Milwaukee), who has unsuccessfully sought state legislation to prohibit such selectivity.
Krusick pointed to six incidents reported to the state nursing home ombudsman program last year, contending that patients were denied admiss ion because Medicaid would pay their bills. The practice is referred to in the industry as "financial screening."
He said studies hav e shown a rise in mortality and illness in such situations as a direct result of the move.
A 1990 federal court decision said nursing homes could not set aside only a portion of beds for Medicaid patients; and there are anti-Medicaid discrimination provisions in both the 1987 and 1993 Omnibus Budget Reconciliation acts.
Both the state nursing home ombudsman's office and the National Citizen's Coalition for Nursing Home Reform have, on separate occasions, appealed to federal authorities to enforce these provisions, but, so far, to no avail.
Consequently, "there is no across-the-board prohibition" on picking and choosing nursing home residents, said Sauer. Nursing homes must consider a number of factors when making such a decision, he said.
The issue boils down to money.
According to 1997 state statistics, the average daily rate the state will pay for a skilled nursing care Medicaid patient the highest level of care is $92, compared with $124 for an average private pay patient.
State had no choice but to close Mount
Milwaukee Journal Sentinel October 22, 1998
The owners and operators of Mount Carmel nursing home have no one to blame but themselves. Not the state, not the federal regulators and certainly not their overworked, overloaded nurses and other employees.
The state gave Mount Carmel three months to turn this abysmal situation around. But when inspectors returned last week, they found that extensive problems remained.
Much of the trouble, state officials believe, stems from the decision by Vencor officials to standardize emp loyee benefits at its facilities nationwide. That led to an employee exodus at the sprawling complex here, creating a staff shortage.
Mount Carmel owner faces scrutiny
elsewhere From Minnesota to Florida, Vencor is drawing regulators'
Milwaukee Journal Sentinel October 25, 1998
COMMENT:- Industry spokespersons and their government apologists have when it suited them asserted that financial policies and pressures do not impact adversely on care. This is obvious nonsense. At other times, (e.g. response to lawsuits in Florida) they claim that financial pressures are compromising care. Instead of addressing the problems clearly created by corporate profit pressures, government decided to squeeze the companies by reducing funding in 1997 and so increased the problems. Vencor struggled to reassure the markets (see its marketplace face) while adopting staffing and patient selection policies which mistreated patients and led to plunging standards of care. Mount Carmel is only an example. This article addresses these issues and I have included several extracts.
It was enough bad news for a health care company to swallow in a whole year a state ordering its biggest nursing home closed and 500 frail residents relocated, then topping it off with $400,000 in fines.
But for Vencor Inc., the crisis at its Mount Carmel facility in suburban Milwaukee is only the latest jolt this year to tarnish the Kentucky-based chain's reputation nationally.
In Minnesota: "Pervasive neglect" and life-threatening conditions were found at a Vencor home in Rochester, and officials opened a major investigation of possible Medicaid fraud. A company nurse consultant ordered that residents be diapered 24 hours a day because Vencor would no longer buy bed underpads as a company wide policy, accordi ng to a search warrant affidavit.
In Florida: Vencor told 52 residents they had to leave a Tampa nursing home because of renovations. The move turned out to be a part of a multistate plan to make room for higher-paying private clients rat her than those relying on Medicaid. The evictions, often with short notice, prompted outrage, $880,000 in fines in Florida and Georgia plus investigations in several states. Vencor has discontinued the discharges.
In Wisconsin: Seriously ill patients at Vencor's Family Heritage facility in Wisconsin Rapids were denied medications for as long as a week, according to state inspection reports. The home relied on a Vencor -affiliated pharmacy 79 miles away instead of a closer pharmaceut ical source. Residents were declared in "immediate jeopardy" and regulators imposed a $130,000 fine.
In Washington: The office of inspector general in the U.S. Department of Health and Human Services opened an unspecified investigation into Vencor.
In Kentucky, California and Wisconsin: Authorities opened criminal investigations into alleged neglect of patients at Vencor -owned facilities, including Mount Carmel, where inspectors declared conditions life-threatening this s ummer.
In North Carolina and Minnesota, and at Mount Carmel in Greenfield: Short-staffing sometimes related to labor strife contributed to major problems with substandard care. The company has angered nursing staff, and in the case of Mount Carmel, driven staff members away in large numbers by pushing for benefit cuts for low-paid nurses aides.
The litany of well-publicized woes has led nursing home watchdogs to label Vencor, a hospital company newcomer to nursing homes, as too bottom-line oriented to care for the elderly.
" Vencor has a real corporate problem" in how it treats long-term employees and in its view of Medicaid patients, said George Potaracke, Wisconsin's long-term care ombudsman who directs a sta te agency that investigates care complaints. "This leads me to believe the company is not going to survive in the long-term health field."
By early this year, Vencor complained that its profitability was threatened by low Medicaid reimbursements. Its top official made clear its plan to run specialized facilities serving wealthier clients not dependent on government funding.
"We'll go out of Medicaid in all 300 buildings if we don't start to see a little change in the Medicaid program," Michael Barr, Vencor's chief operating officer, told The Wall Street Journal. The paper said Vencor had withdrawn or begun withdrawing 13 homes in nine states from Medicaid.
But after the public outcry this spring, the company apologized for the handling of the discharges, said it "underestimated the impact" of its plans and reversed course. Barr resigned last month.
Officials scramble to avoid shutdown of
Mount Carmel Kleczka, employees say owner is trying to sell home;
appeal of license revocation to be withdrawn, work ers say
Milwaukee Journal Sentinel October 28, 1998
COMMENT:- This article describes the conflict over the moving of elderly. It reflects political, community, staff and patient points of view. The way out is seen to be to sell the facility to someone else.
Public pressure to avoid the forced move of 500 residents from Mount Carmel Health and Rehabilitation Center grew Tuesday amid strong indications of a possible sale of the Greenfield nur sing home.
Feeling heat from longtime residents who want no part of a forced move, two elected officials strongly endorsed a scenario under which new owners would try to reverse the home's fortunes.
Employees and residents are confused an d concerned about the relocation and all the rumors swirling around the home, several staffers told a reporter.
Nursing home bill runs out of time ::: A
measure to halt evictions of Medicaid patients fades in a
subcommittee, but plans are to revive it.
St. Petersburg Times October 29, 1998
WASHINGTON - A bill designed to prevent nursing homes from dumping Medicaid patients will have to wait until next year.
Democratic Sen. Bob Graham and Rep. Jim Davis, along with Republican Rep. Michael Bilirakis, failed in their efforts to pass legislation that would make it illegal for nursing homes to evict residents on Medicaid.
The bill stemmed from an incident in April, when Vencor Corp. tried to evict dozens of Medicaid beneficiaries at one of its nursing homes, the Rehabilitation and Healthcare Center at 4411 N Habana Ave. in Tampa.
Thompson seeks Mount Carmel buyer Governor
hopes to avoid relocating residents
Milwaukee Journal Sentinel October 29, 1998
Gov. Tommy G. Thompson has joined the effort to find a new operator for the troubled Mount Carmel Health and Rehabilitation Center, state Health and Family Services Secretary Joseph Leean said Wednesday.
She (Vencor spokesperson) said reports Tuesday th at Vencor might withdraw its appeal of the license revocation were unfounded. But she downplayed the appeal as a routine legal reflex in such cases.
Vencor is also fighting termination of Medicaid and Medicare reimbursements to the facili ty, which is slated to take effect in early December. Moss called the cutoff "unlawful."
Mount Carmel meeting brings
Milwaukee Journal Sentinel October 30, 1998
COMMENT: This reporter speaks to relatives and families to explore the intense anguish created by, and the social disruption caused by relocating 504 residents. It reports on a meeting held at the facility.
The relatives fretted over how hard the news has been on residents, many of whom already suffer depression and now cry uncontrollably over the uncertain times that may lie ahead. Zotter and his friends are frank about how bad things got last spring at Mount Carmel. Zotter recalls nights when just one nurse staffed a wing of 70 patients, and frustration ran so high that some of their favorite nurses quit.
Saving Mount Carmel would be difficult
Business Journal-Milwaukee October 30, 1998
COMMENT:- This article discusses the different options - sale, government takeover, - not for profit group to run etc.
For a new owner to turn around Mount Carmel Health and Rehabilitation Center in Greenfield before it loses its license would be an overwhelming, though not impossible task, nursing home industry officials said. Many also said the state or a private operator should step in to keep the 657-bed nursing home from closing and forcing the relocation of 504 frail residents.
Possibilities emerge for nursing home
Catholic group, firm show interest in Mount Carmel
Milwaukee Journal Sentinel October 31, 1998
A consortium of Catholic caregivers and a Waukesha company emerged Friday as potential white knights in the effort to stave off the forced move of elderly residents from Mount Carmel Health and Rehabilitation Center.
. Both potential players expressed interest only in managing the facility, not purchasing it at least in the short-term.
Letter adds to anxiety at Mount Carmel
Unannounced visit by state inspectors upsets some
Milwaukee Journal Sentinel November 1, 1998
COMMENT:- The outcry at Mount Carmel was similar to that in Riverside in Victoria, Australia. Note that Mount Carmel is being closed because of life threatening problems found by regulators. Vencor responds by assuring residents and families that this is not what was found. We must remember that we are talking about the marketplace. Manipulating perceptions for profit - the creation of illusions which substitute for the world we actually live in.
Residents, their families and staff at Mount Carmel Health and Rehabilitation Center Saturday accused the state of patient abuse for distributing an upsetting letter to patients without a warning that it was coming.
They were especially upset with the manner in which the letter was delivered and with a reference in it to current "life-threatening" problems.
The letter, from the state Department of Health and Family Services, stated in part:
"We have conducted several inspections in your nursing home. The inspections revealed serious problems that have not been corrected. Some of these problems are life-threatening. This has forced us to revoke Mount Carmel's nursing home license. That means Mount Carmel may have to close by Feb. 13, 1999."
In a letter Saturday to the residents, Bill Van Offeren, director of Operations in Wisconsin for Vencor Inc., the owners of Mount Carmel, said, "We want to reassure each and every one of you that the state surveys released Oct. 19 found no life-threatening issues of immediate jeopardy or substandard care."
Leean says three parties express interest
in troubled nursing home
The Associated Press November 3, 1998
Three parties have formally notified the state of their interest in acquiring a nursing home that has been ordered to close, a state official said Monday.
Aurora makes offer to buy Mount Carmel Two
other local groups offer to manage, but not to buy, troubled home
Milwaukee Journal Sentinel November 6, 1998
Aurora Health Care (Milwaukee-based not-for-profit) has made an offer to buy Mount Carmel Health and Rehabilitation Center from Kentucky-based Vencor Inc., according to Aurora officials.
The other two known bidders are Laureate Group, a Waukesha-based for-profit company, and a partnership of Catholic health-care providers with assistance from Covenant Healthcare. Both have said their interest, at least in the short term, is in managing Mount Carmel, not owning it.
Court order halts relocation of residents,
Associated Press November 10, 1998
COMMENT:- Any attempt to penalise or remove poor operators is met by a public outcry, by claims of bias or incompetence in inspectors, and by court actions. This is why regulation in the marketplace does not work.
The state-ordered move of residents out of Mount Carmel Health and Rehabilitation Center has been halted for at least 10 days under a temporary court order won by the nursing home's operator.
Vencor Inc., the Kentucky-based company that owns the suburban Greenfield home, showed that many residents "will suffer serious trauma and irreparable harm" if forced to move, said U.S. District Judge Harold Greene of Washington, D.C., in granting the restraining order late Friday.
Vencor's sincerity questioned in Mount
Business Journal-Milwaukee November 13, 1998
The secretary of the state Department of Health and Family Services is questioning Vencor Inc.'s sincerity in finding a new owner or operator to run Mount Carmel Health and Rehabilitation Center in Greenfield. "My optimism for what I thought was a winwin situation last week is significantly diminished at this point,"
State receives plan to save Mount Carmel
Nursing home owner negotiating to have new operator take over;
non-profit group apparently top candidate
Milwaukee Journal Sentinel November 14, 1998
The owner of Mount Carmel Health and Rehabilitation Center presented state officials Friday with a plan that could save the home from closure, state Health and Family Services Secretary Joseph Leean said.
It's not nearly a done deal, Leean said, but the proposal under which a new operator would take over at the 657-bed Greenfield home is promising. Both the owner, Vencor Inc., and state officials are trying to avoid what probably would be the largest nursing home resident relocation ever in the United States.
Buying clout: Vencor Inc., the embattled
owner of Mount Carmel Health and Rehabilitation Center, is turning to
a former top aide of Gov. Tommy G. Thompson for help in its fight
with the state.
Milwaukee Journal Sentinel November 17, 1998
COMMENT:- Lobbying, political donations, marketing are all strategies used by the big chains to get powerful politicians to take up their case. Sun Healthcare used the New Mexico senators in this way. Vencor tries it for Mount Carmel.
Vencor spokeswoman Susan Moss said the Kentucky-based firm recently hired Bill McCoshen as a lobbyist.
Union criticizes plan to let Vencor keep
Mount Carmel Letter says if nursing home isn't sold, state should
take formal control
Milwaukee Journal Sentinel November 20, 1998
COMMENT:- A management arrangement will not solve the long term problem of a dysfunctional profit driven group owning the home. The unions make the point. Vencor tries to avoid selling, probably at a loss.
A nursing home labor union is criticizing a possible management-change plan that would leave Vencor Inc. as the owner of Mount Carmel Health and Rehabilitation Center.
In a letter to Gov. Tommy G. Thompson, the union urges that the state government take formal control of Mount Carmel as a trustee or receiver if Vencor stays in the picture.
A change-of-management plan would not achieve that in the short term, but the state wants any such deal structured so that Vencor would be removed from operating decisions, even if the company retained ownership, said Daniel Stier, counsel for the state Department of Health and Family Services.
A non-profit group of Catholic caregivers led by the Benedictine Health System is negotiating with Vencor to assume operations under a management contract. Representatives of the group met Wednesday with Vencor officials at Mount Carmel.
Milwaukee-based Aurora Health Care has offered to buy the home but has not heard from Vencor in several days, a spokesman said Thursday.
Officials try to avoid evicting
The Associated Press November 25, 1998
Paul Sobocinski, a spokesman for the U.S. Health Care Financing Administration, said Tuesday the agency has extended the November cutoff of funds until at least Jan. 29, allowing Vencor time to prepare a new management plan.
Mount Carmel gets extension for federal
money Regulators give owners extra time to seal deal with potential
Milwaukee Journal Sentinel November 25, 1998
In exchange, Vencor plans to install a non-profit manager, Benedictine Health System, to help get the facility back on track before the termination date, said Paul Sobocinski, spokesman for the U.S. Health Care Financing Administration. - - - - - - - - - The Minnesota-based Benedictines to come in within two weeks as a "temporary manager" while talks continue on a long-term arrangement. - - - - Vencor to drop its legal challenge to the termination of Medicaid and Medicare funding
Mount Carmel gets interim managers
Benedictine Health System, Clement Manor team up to save nursing
Milwaukee Journal Sentinel December 11, 1998 Friday Final News Pg. 1
The state's largest nursing home began a new era Thursday when a team of Catholic care givers took over Mount Carmel Health and Rehabilitation Center in Greenfield.
The group now has less than two months to prove that Mount Carmel is a quality home rather than the 650-bed sinking ship found this summer by regulators, who took the rare step of moving to shut it down.
The move was hailed as a good first step to an ownership change, a condition that regulators agreed would help prevent the closure of Mount Carmel, long a fixture in southern Milwaukee County.
Kapke said council members would implore the new managers to improve the quality of nursing. "Pool help should be eliminated," he said, referring to temporary-help nurses aides hired in large numbers to fill staffing gaps.
New management at nursing home faces
deadline Administrator at Mount Carmel says changes are being made to
ensure positive inspection
Milwaukee Journal Sentinel December 26, 1998
COMMENT:- Note that the new not for profit managers have a problem because Vencor still owns the hospital and the contract with nurses which caused the problem in the first place. If Vencor is bloody minded as is likely they will refuse to renegotiate this and the problems will recur.
The new management team at Mount Carmel Health and Rehabilitation Center is "working feverishly" to meet a Jan. 29 deadline to bring the nursing home up to government-set care standards, according to interim administrator Dick Rau.
Another major issue for the new managers is an existing contract with nurses aides that some employees say could lead to an exodus of staff in the new year if planned cuts in benefits are not stopped.
"If that happens, it's trouble," Rau said about possible staff departures.
But the issue is complicated because the labor contract between nurses aides and Vencor Inc., the national chain that owns Mount Carmel, covers seven Wisconsin nursing homes, including Mount Carmel. Rau said he hoped some resolut ion could be reached before year's end.
Rau said a long-term goal for the home is to reduce reliance on temporary nurses aides, so-called pool help. He estimated that a bout one in three aides working at the 657-bed home was hired from a pool.
Report lists inadequate care at two
hospitals owned by Vencor Inc.
The Associated Press January 10, 1999
COMMENT:- It seems that there was a small hospital on the same grounds as Mount Carmel Nursing home and that Vencor owned another small one nearby. Two reports describe problems in these two hospitals. The second article gives more detail.
State hospital inspectors alleged patients received inadequate care at two for-profit hospitals operated by Vencor Inc. in suburban Greenfield, the Milwaukee Journal Sentinel said Sunday.
Some complaints from relatives of patients allege that poor care led to death, said Beth Stellberg, a state hospital regulator with the Department of Health and Family Services.
Stellberg said investigations were continuing into some cases.
A hospital is attached to the nursing home (Mount Carmel) in Greenfield. The other hospital is a 34-bed facility at a different location. The Mount Carmel hospital has undergone a full inspection and the Vencor hospital has been subject to narrower investigations.
Neglect alleged at 2 hospitals in
Greenfield Major flaws at Vencor centers risked lives, regulators say
Milwaukee Journal Sentinel January 10, 1999
COMMENT:- The same problem of failing to transfer money making patient's when their care demanded it occurred in the case of Tenet/NME. Note that it was relatives and not regulators who exposed what was happening. The publicity about Mount Carmel stimulated them to come forward. The extracts below are rearranged and are not in the exact order of the original article.
Regulators investigating complaints of negligent care have discovered serious problems at Vencor Inc.'s two for-profit hospitals in Greenfield, including the hospital attached to the company's Mount Carmel nursing home, officials said Friday.
Breakdowns in basic systems endangered lives, wrote off some patients prematurely, denied crucial medications, kept guardians in the dark and allowed excessive weight loss and pain, state hospital inspectors have alleged in continuing investiga tions that began in August.
In one case, Vencor Hospital was sharply criticized for poor care of a man who deteriorated badly and was given up for dead, then made a dramatic recovery after transferring to another hospital. The hospital is a 34-bed facility at 5017 S. 110th St.
State hospital inspectors alleged the patient had become dehydrated due to inadequate intravenous fluids, had lost weight and had received sloppy care of numerous bedsores.
A state inspection report strongly suggests that in a case there (Mount Carmel Hospital), a man with develop mental disabilities was put on "comfort measures only" status because Vencor Mount Carmel couldn't provide the care he needed.
The man's guardian later intervened and requested that the man be sent back to his former home, "where they nur sed him back to health," the report says.
After the state investigation of that case, Vencor Mount Carmel was faulted for failing to review questionable care cases, failing to ensure timely transfer out for care the hospital could not pro vide, and failing to see that all care options were explored.
Eventually, the man was put on "allow to expire" status. The state faults the hospital for not communicating at crucial times with the man's guardian and says the hospital did not document whether the guardian at some point agreed t o let the man die.
"The 'comfort measures only' approach appears to be ordered solely because the facility was not able to provide the care that was needed," the inspector alleges.
That well-publicized action (Mount Carmel Nursing Home) apparently prompted complaints from family members and guardians with loved ones at the Vencor hospital at Mount Carmel, and later from people critical o f practices at the other Vencor hospital in Greenfield.
Some of the complaints allege that poor care led to death, said Beth Stellberg, a state hospital regulator with the Department of Health and Family Services, which took the complaint s.
Hospitals are not usually subject to inspection by government health inspectors. ----- But when credible evidence of deficient care is brought to the state, a hospital can lose the no-inspection privilege. -------- Officials decided that deficient practices by physicians, licensed nurses, administrators and dietitians were serious enough to threaten the hospitals' continued participation in the Medicare program.
Minnesota firm agrees to take over Mount
Carmel home Move is a key step toward troubled nursing facility
Milwaukee Journal Sentinel January 23, 1999
Mount Carmel Health and Rehabilitation Center in Greenfield took a key step toward remaining open Friday when Benedictine Health System reached a final agreement to take over as manager of the nursing home.
The next cruc ial test for the facility comes next week, when it must pass a state health inspection to avoid losing Medicaid funding Jan. 29. A funding cutoff likely would close the nursing home.
Mount Carmel gets stamp of approval
Nursing home hears good news just hours before a scheduled cutoff of
Milwaukee Journal Sentinel January 30, 1999
Seven months of turmoil at Mount Carmel Health and Rehabilitation Center ended quietly Friday when state and federal health regulators declared the giant nursing home back in their good graces. --after --- teams of state inspectors concluded a three-day review just hours before a scheduled midnight cutoff of funds to the 657-bed Greenfield home. - - - - The state immediately issued a new license to Mount Carmel LLC, the non-profit corporation set up by the religious partners. The bed limit is 457, still the size of two or more average nursing homes but considerably more manageable than the old setup.
State investigating patient death at
The Associated Press State & Local Wire April 1, 1999
COMMENT:- It is ironic that the person who blew the whistle on Vencor's neglect died as a consequence of the same neglect. Two reports describe what happened.
Donald Garrison was admitted to Vencor Hospital in Mount Carmel, the adjoining nursing home, July 14. He died July 17.
He begged family members to "have a doctor get me out of here," said Bernie Sorano, Garrison's former sister-in-law and a former nurse aide.
The new report said it's likely Garrison went up to 16 hours at a time without re-evaluation by Vencor hospitals. - - - - - The state faulted the following: failure to notify Garrison's attending physician of lab results when they arrived; inattentive nursing care; and an erroneous report that Garrison was on a ventilator.
State report raises questions over care of
Vencor patient who died Attorney general's office confirms
investigation into case of 44- year-old
Milwaukee Journal Sentinel April 1, 1999
COMMENT:- It seems that Vencor's business policies intruded into clinical care and were an important consideration in his death. Not only were there serious staffing problems but Garrison did not get the antibiotic which may have saved his life. Vencor had a money making policy of using only its own laboratories which were so far away that nearly 2 days elapsed before the specimen arrived at the laboratory. By this stage the specimen may have deteriorated to the extent that a useful result was unlikely. As in Tenet/NME, Columbia/HCA and Sun Healthcare decisions made in Vencor's board rooms had a profound influence on care - not only through understaffing.
Seriously ill when trans ferred to the Greenfield facility after getting shoddy care at the adjoining nursing home, Garrison felt ignored during his three-day hospital stay last July, Bernie Sorano recalled.
On Wednesday, a spokesman for state Attorney General James Doyle confirmed that Garrison's case i s under criminal investigation by that office.
Garrison suffered from spina bifida and was a familiar figure at public hearings on issues affecting the disabled. - - - - Last summer, Garrison warned the state that staffing shortages were causing widespread problems at Mount Carmel.
In the new report, state inspectors say Garrison - - - - went up to 16 hours at a time without re-evaluation by Vencor hospital nurses. --- stayed with an ineffective antibiotic too long because Vencor sent a crucial urine test to its corporate-owned lab in Kentucky instead of getting potentially faster local analysis. - - - did not arrive in Louisville, Ky., until 41 hours after it was taken from Garrison, state records show. - - - - the results didn't arrive until about three hours before his death.
(Note:- Vencor had a policy of sending tests to Kentucky.)
While in Venco r's Mount Carmel nursing home, a feverish and exhausted Garrison suffered from a delay in getting to Vencor's in-house hospital, a delay in notifying a doctor of temperature changes and lax nursing follow-up over more than two days, state inspectors alleged last October.
- - the state Department of Health and Family Services -- - - " criticized the lack of an autopsy and noted numerous discrepancies in the rec ord of his care. - - - . The physician did not visit Garrison on July 16 or 17, - - - - Inattentive nursing care and a dearth of nursing notes for such a seriously ill patient. - - - -- differences in the diagnoses listed on his death certificate (cardia c arrest and severe restrictive lung disease as causes of death.) and hospital discharge summary (probable intestinal bleeding that led to shock and cardiac arrest; a urinary tract infection; and fever).
In addition, Vencor Inc., a national for-profit health care chain, is facing a new threat from federal regulators to fix widespread care problems at its other hospital in Greenfield or lose Medicare funding on May 12.
Similar miscommunication related to Vencor's new computerized "Ventouch" medical records system has caused poor care at its two Milwaukee hospitals, state inspectors alleged in January.