Sunday, November 16, 2008

"Bar" Boyle and His Ilk

This is a massive failure of competence, oversight and just plain humanity.... "Gangrene, death follow stay at facility." (DMRegister)

Ruth Louden is a victim of the "system."

"A year ago, Louden was in good spirits and good health. Twice widowed, she lived alone in an immaculately maintained Grinnell apartment where she liked to crochet. She had recently renewed her driver's license and had just returned from a trip to California, where she traveled by herself to visit her daughter. A lifelong Iowan and a graduate of the Music Conservatory at the University of Dubuque, Louden played the piano on a regular basis - and usually from memory

"While at her apartment on Feb. 16, Louden fell, fracturing a bone in her left ankle. Her doctors didn't think a cast was necessary, but they put her leg in a brace and a medical stocking and sent her to Grinnell's Friendship Manor nursing home for short-term therapy."

And then.... "Louden's doctors allegedly gave Friendship Manor written orders to monitor the circulation in her leg and to check her skin every shift for any signs of swelling or redness.

"Over the next four weeks, Louden complained to the staff of 'horrible' and 'excruciating' pain, state inspectors later alleged. During that time, inspectors say, Friendship Manor staff gave Louden pain medication but never evaluated the cause of her pain or pulled back the stocking to examine her leg.

"On March 20, a physical therapy aide at Friendship Manor noticed Louden's leg smelled like 'rotting meat.' She also noticed blood seeping through the stocking.

"Louden was rushed to a local hospital where an emergency room physician noted the smell of 'rotting flesh.' A wound dressing that had been applied at the hospital four weeks earlier appeared untouched, as if it never had been changed at Friendship Manor, inspectors said.

"Louden was diagnosed with gangrene."

It need never have happened at all.... "One of her doctors later told state inspectors the situation was 'very upsetting' because the bone fracture that had resulted in Louden going to Friendship Manor was almost 'nonexistent.' The amputation, he said, was avoidable.

"According to the inspectors, workers at Friendship Manor acknowledged that during Ruth's 25-day stay, they never removed the stocking to check the condition of her leg. She was never examined by a physician while at the home."

The action taken.... "At the recommendation of the Iowa Department of Inspections and Appeals, federal officials fined Friendship Manor's owners $4,050 for each of the 25 days Louden was at the home. They also imposed a $150 per day fine for the 76 days the home needed to correct other alleged problems. Those fines totaled $112,650."

Who is responsible? "Friendship Manor is owned and managed by two for-profit companies based in South Dakota. The president of both companies is Tim Boyle, a real estate developer.

"Boyle did not respond to several requests for an interview. State records indicate he is appealing the fine.

"Boyle has complained to his congresswoman, U.S. Rep. Stephanie Herseth Sandlin, D-S.D., arguing that Friendship Manor was under doctors' orders to keep the stocking on Louden's leg. The doctors told state inspectors they expected the facility's staff to understand that temporarily removing the stocking would be necessary to conduct the physician-ordered skin checks."

Lots of finger pointing. But on the most basic level, why did no one try to get to the root of Louden's suffering?... tell her doctors of her "horrible, excruciating pain."

The negligent, absentee for-profit nursing home owners are bringing out the big guns.... lobbyists.

"Around the same time Boyle was complaining to Congress, the industry lobbying organization he heads began scheduling meetings with Iowa state lawmakers.

"The Iowa Healthcare Association, with Boyle as board president, is now telling legislators that the Iowa Department of Inspections and Appeals is too aggressive in its enforcement of health and safety regulations.

"In one of the written presentations for legislators, the association says the inspections department is 'flogging' nursing homes and blocking seniors' access to health care, in part by imposing huge fines against the owners and prohibiting new admissions until care problems are addressed."

Listen up lawmakers.... maybe Boyle is right. Maybe large fines aren't the answer. How about a little prison time for these negligent elder-abusers?

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