FAYETTEVILLE — Four workers were fired for giving false statements after a patient’s arm was broken at the Fayetteville Veterans Home, the director of the state Veterans Affairs Department said Monday.
“They gave false statements. They were terminated. It’s a new day up here,” said Director Cissy Rucker. Rucker declined to name the employees or their positions, citing the action as a personnel matter.
The Dec. 9 injury to a 90-year-old was re-examined by inspectors from the state Office of Long-Term Care, whose report was released Monday. The report concluded the patient had been abused. The matter will go to federal Medicaid administrators for possible further action. The 74-patient home is already at risk of losing Medicaid program eligibility because of prior problems.
Past administration practices discouraged reporting problems, Rucker said.
“If you reported an issue, sometimes it was you who were put on unpaid leave until the matter was investigated,” she said. “If you’re a single parent with children, you’re going to think about that before you do it.
“Now we have a policy where if you report something, you’re put on administrative leave” but still get paid, Rucker said. “Now people are coming forward, and we’re able to change the way to do things.”
Rucker took over the agency last year after the previous director resigned at the governor’s request.
In this incident, “employees tried to do right, but were stopped by their supervisors,” said Martha Deaver, president of Arkansas Advocates for Nursing Home Residents.
The patient was not identified in the report, which said she began hitting a nursing home worker who was attempting to draw blood for tests. Other workers and nurses at the home attempted to help, then heard a loud pop. The patient was treated for a broken bone in her forearm at a local hospital emergency room. No names were released in the report.
The original statements taken from the workers in the room did not mention that the arm was being held down by a certified nursing assistant when it broke. The first statements said the arm broke as the patient flailed about. The injury, however, was not consistent with one the patient could have caused in that manner, investigators found.
Under questioning, a worker identified in the report as the one drawing blood from the patient when the incident started “began crying and stated, ‘I’m so proud this is over, I couldn’t even sleep that night,” according to the report.
The nursing assistant was holding the patient’s right arm down “while I was cleaning the blood off of the left arm where I had drawn the blood,” the worker said in her statement.
The worker said she was told not to put the nursing assistant’s name or that the patient was being held down in the statement. The worker could not remember who said to omit the information.
After the incident, the supervising nurse for the patient’s ward took the nurse’s assistant who held down the arm “into the room by themselves for about 30 minutes,” according to another witness. When they came out, the supervising nurse gave all witnesses a blank statement and told them to fill them out but omit that the patient was restrained, the witness said.
“This is when (the one who held the arm) said I wasn’t restraining her, I was holding her,” one of the witnesses said. “I did not tell the administrator or (the director of nursing) about what actually happened because after (the nurse) talked to us, I was afraid for my job. I just didn’t know what to do. I’m just proud this is out in the open now. It has been eating at me ever since.”
The supervising nurse was not the first licensed practical nurse to arrive at the scene, state investigators found. A nurse happening upon the aftermath heard the particulars and told those present the incident was an abuse case and would have to be reported.
“Before I got X-ray results and before I got to tell (the nurse in charge on that ward) what I had been told, their stories had changed. I didn’t know what to do since the stories had changed from it broke when they were holding her down to she hit it on a wheel chair then to she did it when she was flailing her arms around.”
The supervising nurse “then pulled all of the (nursing assistants) and myself into the office together and said, ‘Get your stories straight. What happened?’” the nurse-witness’ statement continued.
“No one at that point admitted to holding her arm down. I asked (the assistant who held the arm) why she told me that they were holding her down when her arm snapped. She told me that I must have misunderstood her because that’s not what she told me.”