State calls for fines of nursing home in patient's death
Posted August 11, 2010 2:51 p.m. EDT
Updated August 11, 2010 11:20 p.m. EDT
Chapel Hill, N.C. — State regulators have asked federal Medicaid officials to fine a Chapel Hill nursing home where a nurse has been charged with murder in the death of a patient.
The Nursing Home Licensure Section of the state Department of Health and Human Services recommended that the Centers for Medicare and Medicaid Services fine Britthaven of Chapel Hill $20,000 for violations over a two-day period in February.
Nine of the approximately 25 patients in the Alzheimer's unit at Britthaven tested positive in mid-February for opiates, a class of controlled substances often used for pain management, officials said. Six of them were hospitalized, and 84-year-old Rachel Holliday, died on Feb. 16.
An autopsy wasn't performed on Holliday, but a medical examiner who reviewed her records determined that she died because of pneumonia-related asphyxiation. The report listed "morphine toxicity" as a contributing factor to her death.
Officials have said Holliday and some of the other Alzheimer's patients who tested positive weren't supposed to be receiving any pain medication at Britthaven.
Angela Almore, 44, of 724 Berwick Valley Lane in Cary, was indicted in June on one count of second-degree murder and six counts of felony patient abuse. Almore worked as a registered nurse at Britthaven.
Prosecutors allege that Almore drugged the patients to make them more manageable.
The Nursing Home Licensure Section conducted an extensive investigation of Britthaven, at 1716 Legion Road, and found the facility didn't ensure patients were protected from abuse, its services didn't meet professional standards, unnecessary drugs were prescribed and significant medication errors occurred.
DHHS asked that each of the violations carry a $2,500 fine, which spokesman Jim Jones said would amount to the maximum allowable penalty of $10,000 a day.
"CMS may find something else that they want to do," Jones said Wednesday. "We're looking at two days that we know of when residents were exposed to this risk. The facility took steps to fix this problem pretty quickly."
State Rep. Nelson Dollar, R-Wake, criticized the amount of the fine and said lawmakers need to look at beefing up penalties for patient neglect in nursing homes.
"Twenty thousand dollars for a senior citizen who has died seems awfully small," Dollar said.
Paul Mahoney, a spokesman for Britthaven, said in a statement Wednesday that patient health and safety remains the highest priority for the Kinston-based chain and noted that the Chapel Hill facility has already taken corrective actions.
Immediately after the patients were hospitalized in February, Britthaven tested all staff members of the Alzheimer's unit for drugs in February and placed them on paid leave. Officials also started 24-hour monitoring of patients in the unit.
"It is extremely disappointing to our staff and management that (Almore) allegedly chose to administer medications without a valid order in violation of the law, facility policies and our code of conduct," Mahoney said. "We hope that these criminal actions will not undo years of effort by the many conscientious employees who have followed all the rules and worked hard every day to give our residents the best care possible."