State and federal health officials are seeking penalties
totaling more than $100,000 from a North Side nursing home after five
residents overdosed on heroin inside the facility in February, the
Tribune has learned.
The residents of Continental Nursing
& Rehabilitation Center were hospitalized and recovered, but at
least two used heroin again hours after they were returned to the
facility, even though they were supposed to be on close watch, Illinois
public health department inspectors allege. One of the two overdosed
again.
The department also opened a new investigation into the
facility after the Tribune requested information about a sixth drug
overdose in September 2015.
In that case, a 56-year-old
resident was found on the floor by his bed with five packets of white
powder beside him, a Chicago police report said.
Illinois
law requires nursing homes to notify the Department of Public Health of
unusual events that put patients at risk, but state officials said they
learned of that case only when the Tribune filed a query about it.
The federal Centers for
Medicare &
Medicaid Services, or CMS, has imposed civil monetary penalties totaling $76,000 for alleged violations in the February incident.
Continental
is contesting an additional $25,000 fine from the state public health
department, which says the facility failed to properly monitor and treat
residents with drug addictions.
State officials and
industry representatives said they could recall no similar cluster of
patients overdosing on heroin inside an Illinois nursing facility.
"I have never heard of that. No question that's uncommon,"
said Terry Sullivan, executive director of the Illinois Alliance for
Living, a professional association of facilities that treat patients
with mental illness and substance abuse problems.
Continental,
which has housed a mix of older residents and younger adults with
mental illness, did not admit deficiencies when it outlined corrective
actions it would take — plans that were accepted by CMS in April. "The
facility has ceased admitting any residents with active substance use,"
its plan said.
In a brief interview with the Tribune,
Continental part-owner Moishe Gubin said he was not aware of any heroin
overdoses or other problems at the facility.
"If you are right," Gubin said, "it goes against what our mission has been."
"If
you look at our company historically, we generally give good care,"
Gubin said. "It's not lack of resources or staff, or they cheaped out
and didn't take care of people. You'll never hear about that with us."
Continental
is part of a rapidly growing, South Bend, Ind.-based nursing home
operation that includes more than 50 facilities in eight states, records
show.
Their 13 northern Illinois facilities include one
that earned a top, five-star rating for overall quality from CMS. Four
others, including Continental, were given a one-star quality rating, the
lowest possible, and police and public health inspection records have
alleged unsanitary conditions and negligent care at Continental and some
other northern Illinois homes.
Medicaid and Medicare
last year paid those 13 facilities a total of roughly $150 million, and
the facilities reported a combined 2015 profit of $6 million, according
to cost reports filed with the state. Similar data was not available for
a recently added 14th northern Illinois facility.
Outside
Continental's gray and white building at 5336 N. Western Ave., a sign
advertises "quality nursing services for the elderly."
But
the 208-bed home — which last year earned $11 million from the
taxpayer-financed Medicaid and Medicare programs — reported to the state
in March that 108 of its residents were under age 65 last year, 129 had
been diagnosed with mental illnesses and 29 had felony records.
Chicago
police responded to 60 reports of alleged batteries at Continental from
2011 through 2015, a Tribune analysis of police data found.
Police
also responded in 2014 when a 61-year-old patient broke his hips and
collapsed a lung as he tried to escape the facility by rappelling from a
4th-floor window using six sheets tied together, records show.
Continental
immediately notified the state of that event, but the paperwork fell
through the cracks, state officials acknowledge, and authorities
conducted no investigation at the time.
After the Tribune
inquired about the case, the department dispatched an inspector who
last month reported that the man was not properly supervised although he
had been admitted for treatment of bipolar disorder, depression and
alcohol abuse.
He had been drinking in the facility just
before he tried to flee and had a blood-alcohol level of more than four
times the legal limit when staff found him "on the ground moaning" with a
broken glass bottle and a beer can beside him, according to the state's
report.
Continental is contesting a pending civil malpractice lawsuit filed by the man's family.
On
the day of the five heroin overdoses in February, staff at Continental
suspected that residents were seeking drugs from a female visitor but
did not intervene or report it, a state inspection report said.
A
33-year-old resident told inspectors the visitor was a relative of a
resident and sold "white powder in a small zippered baggie." The
33-year-old snorted the powder and said: "I don't remember much after
that until I woke up and saw the paramedics standing over me."
Another
resident who also overdosed said he paid $25 for the heroin and assured
the supplier that if the drugs were "good" he could triple her money
"in three days at the facility," the state public health inspection
report said.
Continental was cited for not monitoring residents who returned to the facility from the hospital.
A
46-year-old woman who told a social worker she "wants to get sober and
not be an addict anymore" overdosed again her first day back. Another
man nodded off during his interview with an inspector, and a fellow
resident said that man "got high again this morning."
In
addition to the overdose incidents, police were called to Continental in
October 2015 when residents alerted staff to narcotics abuse inside the
facility. Staff searched rooms and recovered paraphernalia for cooking
and shooting drugs that they turned over to police, records show.
Across the country, at least two heroin overdose cases
have emerged in nursing facilities since last year. In a La Porte, Ind.,
case that remains under police investigation, a 64-year-old woman was
found dazed and bleeding from the nose after ingesting heroin at the
Golden Living Center in August. And in November a southern Ohio man was
charged with involuntary manslaughter after allegedly supplying his wife
with a fatal dose of heroin inside a nursing facility.
"We're
a drug-taking society, and it's only a matter of time before this gets
into the nursing homes," said Dr. Harry Haroutunian, physician director
at the Betty Ford Center in Rancho Mirage, Calif.
Continental administrator Jonathan Dixon declined to
discuss heroin abuse at the facility but gave Tribune reporters a
limited tour of the second floor, where the overdoses took place. He
said he did not have permission from "corporate" to take reporters
through other parts of the home.
Those second-floor rooms
no longer house younger patients with psychiatric and substance abuse
problems, Dixon said, only geriatric and post-operative residents. The
rooms were freshly painted, and some beds had been removed to convert
them from triple-occupancy to double-occupancy.
The
complex ownership and management structures employed by Gubin and his
longtime business partner Michael Blisko limit their involvement in
day-to-day operations, according to Tribune interviews and testimony
they gave in civil lawsuits.
The physical facilities
housing Continental and other homes are owned by subsidiaries of the
partners' real estate investment trust, called Strawberry Fields.
Registered in the British Virgin Islands, Strawberry Fields recently
raised $68 million on the Tel Aviv Stock Exchange to expand operations
with a goal of growing by 50 percent a year, according to its public
statements.
Each of the 13 homes in northern Illinois is
operated by a separate company; those companies hire administrators to
run the homes day to day. Gubin and Blisko own a combined 75 percent of
the company operating Continental.
Continental and other
facilities pay a separate consulting company solely owned by Gubin and
Blisko to offer suggestions about management, nursing, billing and
payroll practices.
The consulting company was initially
called New York Boys Management, but that name caused "image trauma,"
Blisko testified in a civil court deposition last year. "People felt
that it wasn't giving the professional identity, if you will, that it
wasn't good for business," he said. The firm is now Infinity Healthcare
Management, records show.
Continental paid Infinity
$313,818 in consulting fees last year, while the 12 other northern
Illinois facilities paid Infinity $4 million in all, state nursing-home
cost reports show.
Facility administrators are in charge
of their buildings and free to disregard Infinity's recommendations,
Gubin told the Tribune. He said he does not read state public health
inspection reports about his homes.
"The person who is the administrator is the one who is responsible day to day," Gubin told the Tribune.
Continental
administrator Dixon later sent the Tribune an email saying: "We
consistently strive to provide the highest quality of care, in a safe
environment."
Full Article & Source:
Chicago nursing home fined after residents overdose on heroin
