January 09, 2002 11:00 pm

By Alice Perry Linker

Observer staff writer

Caring for elderly and ill people is the mission of adult care institutions, but a review of the years records shows that many of the La Grande institutions are not always achieving their mission.

The 2001 public complaint records of nursing homes, residential care facilities and assisted living centers in La Grande indicate a number of complaints have been substantiated against several area care centers. Many of the problems have been corrected.

The most common complaint is neglect of care, said Greg Musgrove, a protective service worker for the states La Grande office of Seniors and People With Disabilities.

Neglect of care can range from failure to monitor an elderly persons eating habits to ignoring the patient who needs a wheelchair. Neglect of care can deteriorate into verbal abuse, yelling at patients, grabbing and even injuring patients.

The review did not include the 250 in-home care givers or the adult foster homes.

Libby Goben, senior program manager for the state senior services office, said that Union County has no ombudsman to advocate for patients or mediate patient and family complaints with an institution. Ombudsmen are not paid for their services.

We need an ombudsman in the nursing homes, she said, but its a volunteer position, and the ombudsmen are not nearly as active as they once were.

Goben said that when an ombudsman enters the picture, he or she has access to the patient or the family and can mediate before a situation gets too serious. Without an ombudsman, often the only recourse residents or their families have is to go through the formal complaint process.

The state senior services office receives complaints and a protective services worker does the investigation, determining whether a complaint is founded, whether harm was done to the patient and whether wrongdoing was done. Serious complaints, if substantiated, can lead to a financial penalty imposed by the state on the home or limitations on admitting new Medicare patients. Rarely is a home closed.

State agencies also rely on annual or biannual surveys of the homes conditions led by the client care division of the states Human Services Department. All nursing homes, residential care facilities and assisted living centers are surveyed regularly. If the homes do not comply with state standards, they are given an opportunity to change their practices and a second survey takes place.

Evergreen Health and Rehabilitation Center on Aries Lane received civil penalties totaling $1,800 during 2001 for several issues surrounding patient assessment and care early last year, including incidents of two patients suffering minor injuries from falls.

Evergreen Health did not receive a passing grade during its annual state client care survey in July, according to the states records. At that time, investigators found problems with treating skin infections, foot ulcers and urinary tract infections. The problems were resolved and Evergreen was certified with all deficiencies corrected as of Aug. 31, according to the records.

Marilyn Kennedy, director of Evergreen Health, said the home is challenging the $1,800 civil penalty and another for $150. She said many of the violations occurred before she became director in July.

Weve initiated a lot of new programs; we visit the residents daily and we have a monthly resident council meeting, she said. Our new director of nursing is an excellent nurse. We both believe in providing excellent care. Were out there daily talking to residents and their families. We want to have the No. 1 nursing home in Eastern Oregon.

Evergreen Health, a corporation with headquarters in Vancouver, Wash., owns 10 care homes in Oregon, including Evergreen Vista on the west end of Adams Avenue.

Only paper compliance

Troy Anderson, Evergreens regional operations manager, said the deficiencies noted in the survey were paper compliance. All in all, it wasnt that we were not taking care of the residents, it was that we were not documenting that we were taking care of the residents.

Evergreen Vista, which cares for people with Alzheimers disease and other dementias, received a civil penalty of $300 during 2001 for a nursing assistants alleged verbal and psychological abuse of residents. The staff member was dismissed, Goben said.

Problems at Evergreen Vista are not severe when you look at the whole system, Goben said.

Look at the people theyre serving people with Alzheimers very difficult, she said. Evergreen Vista is pretty good. They do an excellent job; theyre willing to take suggestions.

One reported complaint alleges that a care giver hit a patient on the head but did not cause any injury. The incident happened after the patient, who was disoriented, allegedly spit on the care giver. The care giver was suspended.

Evergreen Vista received a second civil penalty of $300 earlier this year for an incident in which a patient with osteoporosis was put at risk of injury.

Twin Firs Residential Care Facility, a locally owned home praised by Goben for the quality of its care, did not escape charges of abuse. On four substantiated instances, one care giver verbally abused patients, yelling and cursing at them. Goben said the care giver was dismissed.

Relicensed in July

Twin Firs, 2109 Third St., was relicensed as a residential care facility July 31, after correcting some problems, including poor food storage.

Twin Firs takes people with mental health issues. They are an excellent resource for us, Goben said.

Grande Ronde Retirement Residence on Gekeler Lane also was out of compliance with standards for poor food storage in 2000, but the facility corrected the problem by May and came into compliance with state requirements.

Medication management has proven problematic for several homes, including Grande Ronde Retirement, Twin Firs, Grande Ronde Hospitals Transitional Care Unit, and Ashley Manor, a fairly new residential care facility on Third Street.

Grande Ronde Retirement received a $150 civil penalty last March for an error in giving medicine.

The hospitals Transitional Care Unit was found not to be in compliance when the state survey took place Oct. 25. The concerns included an incident in which a doctors order to change medication was not followed and another in which no plan was written to address one patients pain.

All of the hospitals issues were corrected and the unit came into compliance with state standards on Nov. 28.

Ashley Manor received a number of complaints during 2000, according to state records, but the home fared better during 2001. The states annual client care survey issued a two-year license on Oct. 2, after the home corrected problems with training, according to the public records.

Center changes hands

Ashley Manor is owned by an out-of-state corporation, and the center changed hands during 2001, Goben said. Ashley Manor paid civil penalties totaling $850 in 2001 for incidents from the previous year.

La Grandes newest assisted living home, Wildflower, opened last March and passed its first survey later in the spring. Several complaints were lodged against the home on 16th Street but none has been substantiated, according to the records.

Goben said several facts influence the quality of care, most notably a shortage of nurses. Evergreens Kennedy said finding registered and licensed practical nurses is difficult. Most staff members, however, are not nurses, but are trained at various levels to provide care.

It takes a unique person to serve this population, Goben said. Its hard for (care givers) to get close to people they die, and it takes a lot to deal with the behaviors, incontinence, all that.

Nursing home populations are falling, Goben said, as more elderly people remain in their homes for a longer period.

People dont go into nursing homes unless they have heavy care needs, she said. Either they are really sick or need other types of help.

The nursing home records are open to the public and can be seen at the Senior and People with Disabilities office on Adams Avenue.