Veterans Home Expects More Trouble

‘Culture of Fear’ Cited In Error

FAYETTEVILLE — Regulators will cite the Fayetteville Veterans Home again, this time in a complaint involving restraint of a patient on Dec. 8, the state Department of Veterans Affairs announced Friday.

The department was not at liberty to disclose whether the resident who was restrained was harmed, said Kelly Ferguson, spokeswoman. The inspection report by the state Office of Long-Term Care will include details and is expected within the next 10 days, she said.

This announcement follows the Jan. 15 death of a resident in a negligence case that was not reported to regulators for three weeks. State law requires neglect cases be reported by 11 a.m. the next business day. The home has been barred from accepting new Medicare or Medicaid patients since March 7 after that violation.

“We recognize there was a culture of fear of reporting under a former administrator in Fayetteville,” the department said in its release Friday. “We also know there was very little oversight from the former (Arkansas Department of Veterans Affairs) administration. We have the opportunity now to uncover these problems and utilize training for both the clinical and administrative staff in Fayetteville to the benefit of our veterans.”

The next citation will also probably find some employees of temporary agencies used to fill clinical positions at the home “did not have sufficient documentation for some employee accreditation,” Friday’s statement said.

Both the state Office of Long-Term Care, which inspects nursing homes, and federal regulators cited the veterans home last month for delaying reporting of the negligence death until Feb. 5. The regulators also cited the home for failing to follow up the report by checking other patients for neglect after the death. The Office of Long-Term Care investigation found administrators were aware of the negligence allegation within 15 minutes of the patient’s death. The investigation also found veterans home administrators discussed the case with superiors at the agency’s headquarters before making a report to regulators.

In addition to barring new Medicare or Medicaid patients, federal regulators have also fined the home $7,000 and put the home on notice: It could lose access to the Medicare and Medicaid programs if it does not get its problems fixed.

The former director of the state veterans department resigned at the governor’s request last year. Audits had found about $600,000 in illegal fees collected from 18 residents of the department’s nursing home in Little Rock. Replacement director Cissy Rucker ordered a review that discovered at least $10 million in needed repairs needed at the Little Rock facility. The Little Rock home was shut down in October. A bill to pay for a replacement home is currently before the state Legislature.

The Fayetteville home was cited March 19, 2012, by state inspectors for 22 violations. Problems ranged from medication errors, unsanitary conditions, inaccurate record-keeping and cold or inedible food. A follow-up visit in June found five more medication-error and sanitation issues. In October, the Veterans Department announced the Fayetteville home missed $114,000 in Medicare reimbursements in 2011 because it didn’t file reports in a timely manner. Nadine Huddleston, the Fayetteville home’s director since 2007, left that month.

“The Fayetteville veterans home is continually, year after year, refusing to follow the laws and regulations that all 231 (nursing home) facilities are required to follow — the exact same laws,” said Martha Deaver, president of the Arkansas Advocates for Nursing Home residents, a private, nonprofit group.

If anything, a state agency created for veterans and largely run by veterans ought to be held to a higher standard than mere compliance, Deaver said. “You would think that a department of veterans affairs would want to be interested in taking care of their own,” she said.

Rucker and her deputy director were both at the Fayetteville home earlier this week in efforts to address the problems, Ferguson said.

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