By Alex Rose
MEDIA COURTHOUSE — The former regional director of operations at St.
Francis Center for Rehabilitation and Healthcare in Darby pleaded “no
contest” Wednesday to three counts of recklessly endangering another
person that state Attorney General Josh Shapiro said resulted in the
deaths of three residents in 2017.
Chaim “Charlie” Steg, 40, of
1100 block of Coughlin Street in Lakewood, N.J., is scheduled to be
officially sentenced to six to 23 months of electronic home monitoring
Oct. 25 before Common Pleas Court Judge Anthony Scanlon.
In the
interim, Steg will be placed on home monitoring beginning Wednesday. He
will be given credit for time served on the device when he is sentenced
in six months, according to the plea agreement worked out by Senior
Deputy Attorney General Mark Levenberg, Deputy Attorney General Benjamin
McKenna and defense counsel Art Donato.
“No amount of money, no number of criminal charges brought or pled to
is going to be enough for the families who missed out on their final
years with their loved ones,” said Shapiro at a press conference
announcing the plea Wednesday morning. “But I think it’s important to
remember this: Every resident here in Delaware County and all across the
Commonwealth of Pennsylvania deserves to be safe, they deserve to be
treated with respect and with dignity, and they also deserve to be heard
when they speak up and they speak out.”
Steg was charged with the
three misdemeanor counts by a statewide investigating grand jury that
heard testimony from 22 witnesses and reviewed 78 pieces of evidence,
according to an affidavit of probable cause for his arrest written by
Attorney General’s Office Special Agent Jennifer Nutter. Darby Borough
Detective Brian Pitts was co-lead investigator in the case with Nutter.
The
investigation was launched in August 2017 after staff at Mercy
Fitzgerald Hospital notified Delaware County Services for the Aging of
concerns about the poor health conditions of several residents who had
been transferred to the hospital. COSA, in turn, notified the A.G.’s
Office and Darby Borough Police.
One of those patients, an
87-year-old identified as “B.W.,” died at the hospital Aug. 15, 2017,
due to a massive fecal obstruction in her colon and dehydration,
according to the affidavit. She was already suffering from a urinary
tract infection and sepsis when she came to the hospital, which
ultimately caused her death, the affidavit says.
Another
86-year-old identified as “O.G.” died at the hospital Aug. 20, 2017,
from septic shock and severe dehydration after suffering from Stage IV
pressure ulcers that exposed his tendon and bone, according to the
affidavit. There was no evidence O.G. had received any medical treatment
for his wounds, the affidavit says. St. Francis staff allegedly ignored
concerns from his family, who ultimately were the ones who got him into
the hospital Aug. 13, 2017, a week before his death.
The third
resident, 87-year-old “L.C.,” developed a severe pressure wound that
should have been noticed weeks earlier if properly trained staff were
performing routine care, the affidavit says. The wound required
debridement at the hospital Aug. 15, 2017, after which L.C. returned to
St. Francis. Staff there again failed to properly monitor her, however,
and she died Sept. 7, 2017, after developing a bacterial infection in
her blood.
A medical expert reviewed each of the patients’ records
and determined their deaths were not isolated incidents, but the result
of systemic failures within St. Francis, the affidavit says.
The
grand jury also determined the injuries and deaths the three residents
suffered were avoidable and the result and Steg’s failure to address
well-known staffing shortages at the 273-bed facility.
“Despite
making multi-million dollar annual profits, Steg … recklessly chose not
to adequately invest in adequate staffing and did not adjust other
operational factors within his control to mitigate the ongoing staffing
crisis,” the affidavit says. “St. Francis was understaffed on a daily
basis for months at a time and much of the staff they did have was
inexperienced and not sufficiently trained.”
One former administrator told the grand jury that staffing at St.
Francis was a “revolving door,” while another former staffing
coordinator testified she had complained more than 40 times between
December 2016 and April 2017 about staffing shortages, but Steg did
nothing about it, according to the affidavit.
Steg additionally
discouraged or forbade outside agency staffing because it was more
expensive, creating further strain, the affidavit says. Many witnesses
said new hires rarely stayed longer than orientation.
Shapiro
indicated these are the only charges that will stem from this
investigation and declined speaking about any other ongoing
investigations his office might be conducting in the wake of the
COVID-19 pandemic, which also left many medical facilities and nursing
homes short staffed.
The Pennsylvania Department of Health
conducted a survey of St. Francis in August 2017 and found widespread
and systemic deficiencies, including multiple cases of neglect,
according to the affidavit.
St. Francis’ staffing budget called
for three direct care hours per resident per day under Steg’s
leadership, according to the affidavit, but DOH found 4.1 hours was
needed, given the conditions there and the acuity of residents.
The
department nearly shut the doors on the facility, but instead declared
an “Immediate Jeopardy” situation that Shapiro said barred any new
residents from coming in.
Shapiro said two related business
entities – “1412 Lansdowne Operating LLC,” which did business as “St.
Francis Center for Rehabilitation and Healthcare” and ran the day to day
operations of the facility, and “Catholic Facilities Operating LLC,”
which paid Steg’s salary – have also agreed to pay a $1.2 million civil
settlement as a result of the investigation.
The settlement
requires St. Francis to maintain an increased minimum staffing level and
undergo an additional year of monitoring to ensure compliance through
quarterly audits by the Department of Health – violations of which will
extend supervision by another three months for each infraction, Shapiro
said.
He added that the businesses have already paid fines of
$550,000 to the Centers for Medicaid and Medicare Services and DOH, and
will additionally place $600,000 into escrow for the benefit of St.
Francis residents. They will also provide $100,000 to the non-profit
group Center for Advocacy for the Rights and Interests of the Elderly,
Shapiro said.
“It is the law to uphold the obligation to keep
residents safe,” said Shapiro. “If a facility cuts staff to the point
that they can’t give residents the care they need, we’re going to find
out and we’re going to hold them accountable.”
In addition to
electronic home monitoring, Steg will have three years of probation and
will not be able to staff, manage, own, or operate the nursing,
clinical, or medical services of any skilled nursing facility for five
years. He will also pay a $15,000 fine and a total of $21,213 in
restitution to the families of the victims.
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