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Santa Cruz Skilled Nursing Center cited, fined for mistreating patient

Original source:

Santa Cruz Sentinel
Jondi Gumz
Feb. 19, 2011

SANTA CRUZ -- The state issued a Class B citation and fined Santa Cruz Skilled Nursing Center $850 for an incident last month in which the administrator shook a cigarette out of the hand of a patient in a wheelchair, then removed cigarette packs from a locked drawer in the patient's room without informing her.

"The facility failed to treat Patient 1 with dignity and respect," the state Department of Public Health concluded after an investigation of the Jan. 24 incident.

The administrator, Yvette Bonnet, is no longer employed at the 162-bed nursing home, according to a correction plan signed Feb. 8 by Kevin Hogan, president of San Mateo-based Nazareth HealthCare, which took over in November 2007.

"She abused me," Margaret "Bunny" Haase, 66, whose complaint prompted the investigation, said in a telephone interview Friday. "I want her license out."

As for the fine, Haase said, "I feel it should be bigger."

She said residents thanked her for calling in the complaint.

The previous administrator was better, "most definitely," said Haase, who has lived at the nursing home "going on three years."

Last year, the nursing home had no Class B citations, but in the past three years had eight, more than others in the county.

Hogan was not available Friday, but the correction plan required staff training in residents' rights to be completed by Feb. 18. The state accepted the plan Feb. 10, closing the complaint, according to health department spokesman Ralph Montano.

Nursing homes are required by state law to notify the state within 30 days when administrators are terminated. California's Nursing Home Administrator Program is required to keep a current list of nursing home administrators placed on probation or had their licenses suspended or revoked within the last three years. The list is available to the public upon request.

A deficiency report prepared by the state confirmed Haase's description of the incident.
She was in her wheelchair on the patio, a smoking area, smoking a cigarette, when Bonnet asked her to put it out.

When Haase refused, Bonnet came behind her, grasped her left wrist, then shook her hand and arm for five seconds. The cigarette fell out of her hand.

Haase went to the library area, making phone calls to report mistreatment. When she returned to her room, she found four packages of cigarettes missing from a locked drawer and her personal belongings in three drawers disturbed or misplaced.

The state investigator, visiting the next day, observed reddened skin on Haase's left wrist. Haase showed her how the locked drawer could be accessed without opening the lock by removing the drawers above it.

The incident left Haase feeling "like her room was ransacked and she was robbed."

The administrator told the investigator that "she acted reflexively" because the patient was not allowed to carry smoking materials for safety reasons, according to the report. The administrator also said "more appropriate action would have been to move away" and that the cigarettes should not have been removed without first notifying the patient and her responsible party, according to the report.

The corrective plan involved monitoring Haase for emotional distress, offering reassurance so she would feel safe, and requiring training for all staff on residents' rights, including refusing treatment and notification before belongings are removed. Other topics included reporting of abuse, and how to communicate and deal with residents who have challenging behaviors.

The nursing director is responsible for training managers and ensuring that any resident rights' issues are discussed and addressed via staff meeting, with all issues brought to quality assurance to ensure follow-up.
Compliance will be monitored by the facility via the grievance procedure, quality assurance system and complaints made by staff, residents or regulatory agencies.

Kurtis Lemke, 44, president of the residents' council at the nursing home, had complained about other changes instituted by Bonnet, such as removal of microwaves and mini-refrigerators from residents' room for patient safety, no hairdresser services since September and no weekend maintenance staff.

According to ombudsman Wayne Norton of Advocacy Inc., which monitors nursing home complaints in the county, Hogan was advertising for a hairdresser and a weekend maintenance person.

Hogan put a microwave in the staff room and a refrigerator at the nurses' station for residents, solutions that did not satisfy Lemke, who cannot leave his bed because of multiple sclerosis.

"The food ain't so happy here," said Haase, who has not used the microwave in the staff room.