A task force formed after Hillside Health Center closed in June finds that an ombudsman began complaining three years ago about shaky conditions there.

12:45 PM EST on Monday, November 22, 2004

BY JENNIFER LEVITZ
Journal Staff Writer

The Alliance for Better Long Term Care, which holds a state contract to act as ombudsman for the elderly, warned the Health Department at least six times about poor care and financial problems at Hillside Health Center in Providence.

Among the findings in a task force report released today by Lt. Gov. Charles J. Fogarty are that Roberta M. Hawkins, executive director of the alliance, started complaining to the Health Department in 2001 about alarming conditions and shaky finances at Hillside.

The final report of the task force, formed after the closing in June of the 165-bed nursing home, raises additional questions about the Health Department's response to conditions at Hillside.

According to the final report by Fogarty's 12-member task force, of which Hawkins was a member, on Aug. 8, 2002, Hawkins notified the Health Department, the Department of Human Services, and the attorney general's office that vendors at Hillside were complaining about past-due accounts. This was not her first complaint about Hillside -- she had already complained in 2001 particularly about staffing and conditions in the Alzheimer's unit.

Her notes, included in the task force report, detail her complaints in August 2002: "Now all [vendors] are on COD . . . [the director of nursing] has been out for two weeks and there is a rumor she is not returning. Other nurses have left and the place is short-staffed. The administrator is staying in his office with door shut and not coming out. Another caller reported that it is believed the nursing home uses time cards of people who do not exist."

Six days later, she reported to the Health Department about calls the Alliance for Better Long Term Care received from "family members with complaints about not having staff and pool nursing staff not being called in. Also no air conditioning, no drinks, residents dressed inappropriately for heat. [Department of Health] response was that they would discuss with clinical supervisor and get back to Alliance. DOH staff noted that last time he was there, administrator started crying."

In her notes, Hawkins wrote, "ANOTHER EDMUND COMING!" referring to Edmund Place, a now-defunct East Providence nursing home owned by former Sen. John Orabona, and managed by a firm owned by the family of Antonio L. Giordano, who owned Hillside.

Giordano also partly owned the Coventry Health Center, which entered state bankruptcy proceedings in 2001 and was bought by a Connecticut chain.

On Aug. 15, 2002, Hawkins called the Health Department's Facilities Regulation Division to say it was even "hotter" inside Hillside. Her notes say: "Families upset as no water being passed; residents overhead asking for drinks; Alzheimer's floor smells really bad."

On Aug. 16, the Health Department contacted the Alliance for Better Long Term Care to say a nurse had gone to Hillside the day before and that two other nurses would visit on this day.

That visit by the Health Department cited Hillside for deficiencies related to "pharmacy services, drug shortages."

Hawkins received another complaint on Oct. 4, 2002. The organization's notes say: "Complaint received from family member regarding neglect of a resident needing skilled care who ended up in hospital in ICU with dehydration, infection, and renal failure who later died. Family did not file official complaint with DOH, but this was reported by [ombudsman]."

That October 2002, in an annual inspection, the Health Department found 17 defiencies at Hillside, including two residents with severe weight loss, and recommended an $800 fine per day. Hillside, however, filed a "plan of correction," was not sanctioned, and continued to accept residents.

After that poor inspection, the Alliance for Better Long Term Care wrote the Health Department noting "concerns regarding residents' quality of life and life being jeopardized by nursing home practices." The Alliance requested "immediate attention as residents needed action to proect their well-being."

The next month, November 2002, the alliance received a complaint from a family about a resident "who was now unresponsive in hospital with skin breakdown and other serious problems. Alliance clinical director found many questions regarding resident's clinical care at nursing home including appropriateness of medications. Patient was eventually discharged to another nursing home, but had to return to hospital and died there."

One year later, after additional complaints by the ombudsman, after 9 out of a sample of 13 residents had bedsores in one inspection, and after employee checks bounced, the Health Department stopped admissions at Hillside.

Among the 42 recommendations by the task force, whose members included House Majority Leader Gordon D. Fox, Sen. Rhoda Perry, and representatives from both the nursing home industry and senior advocacy groups, are more transparency for the finances of nursing homes, stronger enforcement by the Health Department, and better cooperation among agencies that oversee long-term care. Fogarty plans to file legislation and believes some of the recommendations can be put in place right away.

In a statement, Fogarty said there were multiple points in the system at which the tragedy of Hillside could have been prevented. "Unfortunately, each and every time, someone failed to take the appropriate action."