State launches criminal probe of Chapel Hill nursing home
Posted February 19, 2010 2:05 p.m. EST
Updated February 19, 2010 6:57 p.m. EST
Chapel Hill, N.C. — State officials on Friday launched a criminal investigation of a Chapel Hill nursing home where Alzheimer's patients tested positive for strong pain-control drugs that they weren't supposed to be receiving.
The State Bureau of Investigation and the Medicaid Investigations Unit of the Attorney General's Office were looking into possible wrongdoing at Britthaven of Chapel Hill, at 1716 Legion Road.
"We've been in touch with some law enforcement," said Jeff Horton, who heads the state Division of Health Service Regulation.
The division's Nursing Home Licensure Section sent a team of inspectors to Britthaven on Thursday to gather information about drugs administered to Alzheimer's patients there.
Three 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 officials to express concerns about the patients' situation.
A Chapel Hill police report states the concerns involved possible over-medication of the patients.
Horton said Thursday that blood tests showed "what looked like drugs in their system (that) they weren't prescribed."
Britthaven officials then tested all of the approximately 25 patients in the Alzheimer's unit for drugs. Six tested positive for opiates, a class of controlled substances often used for pain management, officials said. Three of them were hospitalized as a precaution, officials said.
One of the first three patients hospitalized, 84-year-old Rachel Holliday, died Tuesday. None of the other five hospitalized patients has returned to Britthaven, but it's unclear if they remain in the hospital.
Chapel Hill police, who met with an official of Kinston-based Britthaven on Wednesday, asked the SBI to take the lead in the investigation due to the complexity of the case.
"They look at things like abuse, neglect, that sort of thing. So, they were interested in this when they first learned of it," Horton said.
Experts say abuse is a serious concern at facilities involving patients with Alzheimer's or dementia.
"The tendency to control behavior with drugs is there," said Gail Holden, director of senior services at Wake County Human Services.
The practice is called chemical restraint, and Holden said some cases are malicious while others are simply mistakes. The latter is especially true with elderly patients who have complicated drug regimens, she said.
"We get a lot of complaints about medication errors," she said.
Before the team of Nursing Home Licensure Section inspectors reports its findings, members are awaiting the results of lab tests to determine what medications could have contributed to the opiates found in the patients.
"Some of the medications some of the folks are on, once we got researching, could cause false positives (for opiates)," Horton said.
He said Britthaven is taking the necessary steps to ensure residents at the nursing home are safe. The facility has replaced some of its medication and eliminated some dietary supplements, he said. The Alzheimer's unit is also now monitored around the clock.
On Wednesday, the nursing home tested all staff members of the Alzheimer's unit for drugs and sent them home. The drug tests came back negative, but they remain on paid leave, a company representative said Friday.