Nursing home staff on leave after patient death

Chapel Hill, N.C. — The staff of the Alzheimer's unit in a Chapel Hill nursing home was put on paid leave Wednesday following positive drug tests by several patients and the death of one, officials said.

Six Alzheimer's patients at Britthaven of Chapel Hill, at 1716 Legion Road, have been hospitalized since the weekend, including 84-year-old Rachel Holliday, who died Tuesday, officials said.

Phillip Hill, vice president of operations for Kinston-based Britthaven, which operates nursing homes in North Carolina, Kentucky and Virginia, met for two hours Wednesday with Chapel Hill police to discuss the situation.

Hill said managers are doing everything they can to ensure patient safety, noting Britthaven called for the meeting with authorities. Managers also placed the Alzheimer's unit under 24-hour supervision, he said.

Holliday and two other Alzheimer's patients were taken to UNC Hospitals on Sunday after nursing home managers said they were acting unusual. Hospital officials then contacted police, regulators with the state Department of Health and Human Services and Britthaven managers to express concerns about the patients' situation.

A Chapel Hill police report states the concerns revolved around possible over-medication of the patients.

Britthaven officials then tested all patients in the Alzheimer's unit for drugs, and officials said six more tested positive for opiates. Three of them were hospitalized as a precaution, officials said.

Testing positive for opiates is not unusual in Alzheimer's patients. Opiates are used for pain management, and some medications produce positive results.

Holliday's family said physicians at UNC Hospitals told them that she died of complications from pneumonia.

None of the other five hospitalized patients had returned to Britthaven as of Wednesday evening.

On Wednesday, the nursing home tested all staff members of the Alzheimer's unit for drugs and sent home, officials said. Other staff took over management of the unit.

DHHS spokesman Jim Jones said inspectors with the Division of Health Service Regulation’s Nursing Home Licensure Section haven't yet visited Britthaven. The inspectors usually don't announce such visits in advance, he said.

Capt. Bob Overton said Chapel Hill police haven't launched a criminal investigation. Police are waiting to see how state regulators handle the situation, he said.

A complaint survey reported early this month showed that Britthaven of Chapel Hill is on a national nursing home watch list. According to the report, an inspection last year found at least one area that "caused actual harm to a patient and or subjected patients to immediate jeopardy."

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"It's past time to start talking about end of life and quality of life issues in this country."

And you seem to think that Doctors don't talk to patients about end of life? The do and have done for years, and years.

The Government has no business at all in mandating that Doctors talk about end of life, and yes liberals, it is in the proposed Health Care Bill. Take time to read it and you will see. I have.

When both my parents got to the point where they knew, and my brothers and sisters knew that it was time, I signed the no code orders on both of them. Then stayed by their side giving them comfort until they died. This is a matter for families to make, not any Government.

TomLynda
February 18, 2010 9:49 a.m.

Is mulecity suggesting (gasp) death panels? The problem in a rational approach to end of life issues is that addressing death and the care leading up to it has become a political issue, not a decision based on quality of life or advanced directives by the patients themselves while they are still competent to make a decision. A certain group of politicians started a misinformation campaign equating the proposal that physicians be paid for discussing this with their patients with the government killing grandma. Lets face it, we are all going to die sometime. When you are in your 60's and 70's it's probably going to be sooner than later. What's wrong with your doctor spending some time talking to you about your wishes in end of life care and the doctor getting reimbursed for it?

miseem
February 17, 2010 6:58 p.m.

Tough story. Brings back memories of when my mom was passing (slowly and painfully) and I was encouraging the assisted living staff to administer *more* morphine so she could slip off painlessly and, frankly, sooner. They pushed back ("we're not Dr. Kervorkian, sir!") and they were right to from an ethical/legal standpoint. I don't regret what I did to make her comfortable, but this situation does look odd. If my mom was getting doses more often than normal because I was demanding them, that's one person and one situation. If everybody in the section is doped to the point that medical professionals are calling the cops, that sounds like something else.

FWIW, in my experience both the patients and the caregivers in such settings have a very hard row to hoe, as they say. A nursing environment is a very hard, depressing, emotionally devastating, and demanding environment. And I haven't worked in one, I've just spent a fair amount of time visiting one.

ThatGuyAgain
February 17, 2010 5:56 p.m.

When will the Dept of Health and Human Svcs step up to the plate to shut down these bad nursing home owners that get over with POOR QUALITY staffing? Headcount is one thing, undereducated staff is another. It shouldn't be a -you get what you pay for- system when it comes to taking care of our elders. Better laws are also needed.

kiediss
February 17, 2010 5:23 p.m.

Everybody reading this needs to go back and read the article about the 70 year old man killing his wife, then himself due to health concerns. It's past time to start talking about end of life and quality of life issues in this country.

mulecitybabe
February 17, 2010 4:30 p.m.