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Watching out for nursing home abuse, neglect

2013-05-18T22:32:00Z 2013-05-27T00:11:06Z Watching out for nursing home abuse, neglectJON Glens Falls Post-Star

Tiffany Vanalen, a 38-year-old licensed practical nurse from Schuylerville, didn’t intend to harm anyone last June, which is when state investigators say she neglected to give five residents at Pleasant Valley nursing home their drugs, then falsified documents to indicate she had, her lawyer said.

Vanalen, who has worked in the elder care field for more than a decade, was a victim of circumstance in a nursing home facing an exodus of employees and increasing public scrutiny, according to her lawyer, George Lamarche.

“I think understaffing could be a problem. Too many patients assigned to a single nurse could be a problem,” Lamarche said Tuesday. “The sad thing is, she’s being singled out and targeted.”

Vanalen’s arrest in August on felony neglect charges followed a damning state Department of Health investigation the previous spring that found bloody rags in the kitchen at Pleasant Valley and drugs going to the wrong patients.

The 15 felony charges filed against Vanalen have since been reduced to a handful of misdemeanors by the state Attorney General’s Office. No court date has been set in the case.

Vanalen’s story is one of nursing home staff, already stressed by an ongoing privatization effort, grappling with low wages, daunting hours and administrative upheaval.

It’s a tale that repeatedly plays itself out with different actors and similar results throughout the region, state and nation, officials said.

“They can have an entire wing to themselves. They don’t pay enough. These poor girls work long, hard hours,” said Harriet Bunker, ombudsman for Warren County’s Office for the Aging.

Bunker handles and investigates complaints about public and private nursing homes throughout the county.

“I know it’s a matter of cost but somebody has to absorb it,” she said.

Most complaints are minor, often concerning transfer requests or a faulty call light used to beckon nurses, Bunker said.

Federal officials testified to Congress in 2010 that 7 percent of complaints to state and county ombudsmen concerned provable cases of abuse and neglect.

A certified nurse’s aide, the lowest rung on the nursing home care ladder, can make as little as $10 an hour, while caring for residents afflicted with dementia.

Persistent staffing shortages can mean double shifts for all medical personnel, and facilities increasingly rely on outside agency nurses who are not familiar with individual residents of nursing homes where they’re assigned.

New York doesn’t regulate the number of patients that can be assigned to a single nurse or aide. Most homes base a nurse’s maximum allowable case load during a shift on the specific needs of the resident population. More acute patients require greater time and effort, officials said.

Training matters

Renee Groesbeck overhauled training of Pleasant Valley’s staff after taking over following the state review. She is credited with stabilizing the county nursing home, which at one time was bleeding staff and on the brink of financial collapse.

Installing uniform training patterns and expectations among Pleasant Valley’s medical staff, while stabilizing the full-time staff to avoid a reliance on outside nurses, were the keys to righting the facility, said Groesbeck, Pleasant Valley’s executive director.

But not all cases of abuse and neglect in nursing homes can be blamed on stressed, overworked personnel.

A 2011 study of abuse of New York’s elderly living in various environments sponsored by the state Office for the Aging and Cornell University concluded actual abuse rates are 24 times higher than what gets reported to authorities.

That number could be even higher if looking solely at the nation’s 3.2 million nursing home residents, because that population is even less capable of speaking for themselves, reform advocates said.

Not-for-profit nursing homes tend to have fewer deficiencies than their for-profit counterparts, because more resources are spent on staff and training, according to multiple studies.

Fort Hudson Health System falls into this trend relative to its public and for-profit local competitors, as the nonprofit nursing home in Fort Edward has for years had fewer deficiencies noted in state inspections.

But even so, a late 2012 review found five of 29 patients randomly selected by the state for review didn’t receive their drugs as prescribed by a physician.

“If the nurses would follow the policy and protocol, that would be avoided,” said Holly Vaughn, Fort Hudson’s director of nursing.

Too many deficiencies

Warren County’s Westmount Health Facility and private local nursing homes, such as The Pines at Glens Falls, The Stanton Nursing and Rehabilitation Center in Glens Falls and Indian River Rehabilitation and Nursing Center in Granville, have all exceeded the state average for number of deficiencies found in recent inspections, according to the state Department of Health. Most of those issues were considered relatively minor by state inspectors.

The state’s method of review has for years been widely criticized by nursing home administrators, who consider it a method of scaring the public with strong language based solely on a two-week review.

“We can say without a doubt that deficiency statements sound a lot more ominous than the reality,” Fort Hudson’s Executive Director Andy Cruikshank said, noting his facility has been deficiency-free so far this year. “It could be as simple as some received their medications a half-hour late and it sounds like the entire drug delivery system has fallen apart.”

Abuse cases can run the gamut from ignoring a patient with bed sores to, in extreme cases, rape.

But for abuse to be recorded, it first has to be reported.

“A crime is a crime no matter where it occurs. It’s another world in a nursing home. People just don’t report these things,” said Robyn Grant, public policy director for advocacy group, National Consumer Voice for Quality Long Term Care.

At Indian River, the state Department of Health is investigating a case in which a man fell, and later died, but who may, in the interval, have been left alone for hours.

The Washington County Coroner’s Office ordered an autopsy on the body of the man, whose name was John “Punk” Zellars. The results of that autopsy haven’t been released by local or state officials.

A recent investigation by, an online news organization, found Pleasant Valley topped the list of New York’s 632 nursing homes for errors found by state inspectors from 2009 to 2012. (See box on front page.)

Twenty “serious” deficiencies were found at Pleasant Valley over that time, accounting for more than $100,000 in fines leveled against the Washington County facility. The state has yet to level the fines for last year’s inspection.

State inspectors left Pleasant Valley satisfied last week, the second consecutive survey the once-troubled facility has passed this year.

Copyright 2015 Glens Falls Post-Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(7) Comments

  1. letdown
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    letdown - September 21, 2013 1:50 pm
    This is frustrating and offensive that so many intelligent, influential and compassionate people can emphasize over and over again about the deficiencies in these facilities; the health violations, lack of staffing, lack of leadership, the neglect and alleged abuse due in part to the deficiencies outlined above, yet the leaders responsible are not held accountable. Those who are paid to be responsible have not been held accountable! Instead, this nurse and others are victims of opportunity to be used as scapegoats to draw attention away from the real problems at this facility, very serious, long-term issues well outlined in the damning state Department of Health investigation for this facility. I have no faith in the justice're guilty until proven innocent and god forbid you can't afford to fight for your innocents because you will be forced to accept a deal with the devil to end the nightmare!
  2. kscott1011
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    kscott1011 - May 21, 2013 6:20 am
    I agree, counrty2. Both my mother's sister and her granddaughter (my daughter) work in nursing homes where yes, they are overworked, but not to the point where the care that the residents receive is inadequate. Where my mom was they didn't even brush her teeth regularly. Basic human needs were not provided to her, or any of the other residents that I could see. Many were sitting in their own defecation, calling to staff to come and clean them up. I was there every day, as were my dad, my brother, and a care giver that we hired to provide the things they weren't providing. Despite my frequent complaints and their constant reassurances, all we really got was lip service. What I could have, and should have done differently was to report them. The lack of adequate, trained staffing is a result of corporate greed and the almighty profit motive. I will always feel deep regret for not being a better advocate for mom, but I appreciate your kind words.
  3. country2
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    country2 - May 20, 2013 8:31 am
    I hope you, kscott1011, can soon find a way to forgive yourself. Like so many, you trusted the integrity of perfect strangers which is currently all we can do. Too many individuals want to sweep these issues under the rug and shift the focus to all that is right in nursing homes. Yes, there are many compassionate, competent professionals caring for many happy residents. I commend them for their wonderful work. That having been said, we should honor those conscientious workers by giving them the legislation and electronic surveillance support needed to ensure that incompetent coworkers do not continue to tarnish the reputation of an honorable profession. We must unite to give voice to all those voiceless elders who have been forgotten. I am confident that the day will come when family members will be able to, from their living rooms, view live, secure internet feeds connected directly to their loved-ones nursing home rooms, and common areas. Only then, will they be truly safe.
  4. ganondagon
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    ganondagon - May 20, 2013 7:57 am
    Bravo to Resident of GF !! Walk in someone's shoes before judging.
  5. kscott1011
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    kscott1011 - May 19, 2013 8:01 pm
    I completely relate to the comment by country2. My mother was the victim of neglect while in the care of a local nursing home, and I will never, ever forgive myself for not being able to find a way to protect her. She was not fed, bathed, or changed regularly, was taken on and off medications without informing her health care proxy, was taken to appointments outside the facility without our knowledge, and was not provided with the rehab she was there to receive. When we finally got her out of there, she was found to have stage 4 bedsores. I would sue, and easily win, if my father would allow me too. He just wants to put it all behind him, as she died shortly after we got her out of there I know that my mother suffered needlessly, and I could give a hoot about the understaffing, inexperience, etc problems that they have. Bottom line, a human being was treated worse than any animal would be treated, and this nursing home, a for-profit organization, is responsible for her misery.
  6. country2
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    country2 - May 19, 2013 5:20 pm
    Nursing home abuse and neglect may or may not be commonplace, however if your loved one is a victim, you live the rest of your life haunted in knowing that you didn't protect them as you should have. You lie awake at night wondering how bad Mom's back pain was in the 12-14 hour period in which someone failed to bring her her pain medicine. You cry when you think of Dad sitting on a toilet needing assistance while no one responded to his call bell. You ache as you remember the time, during a visit, when you happened to notice that the Dad's oxygen tank was empty or the time you arrived for an 11am visit and found Mom sitting in her nightgown waiting for help getting dressed. And the most helpless feeling of all came when you were told that transferring a patient from one facility to another would be a lengthy process. Walmart relies on surveillance video to ensure the safety and security of its patrons and products. In nursing homes, we rely on the integrity of perfect strangers.
  7. Resident of GF
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    Resident of GF - May 19, 2013 9:39 am
    This makes me frustrated. If you are going to target a specific nursing home that was once a well run facility and harp on it constantly in the public newspaper do you think they are going to attract the best and brightest nurses? Leave these poor residents, their families, and nurses who work for a living alone. Nobody makes mistakes on purpose to hurt anyone and if they do they are a criminal. This poor girl had no supervision from a head nurse or nursing supervisor that cared about the facility. Their leader was from an agency that paid her a TON of money just to work at Pleasant Valley. She didn't choose to work there she did it for the money. Please HELP Pleasant Valley. Don't hurt it anymore than it already is.


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