Everett nursing home accused of neglect after death of man, 97

By Diana Hefley, Herald writer October 16, 2009   EVERETT — An Everett nursing home is being accused of neglecting a 97-year-old man and allowing his penis to slowly rot off.   A lawsuit was filed against the Everett Rehabilitation and Care Center earlier this week. The lawsuit alleges that nursing home staff failed to adequately care for a patient who had developed penile cancer. The man died March 31, 2008, about two weeks after he was rushed to the emergency room and doctors made the grim discovery.   They were the first to report that the man’s penis had disintegrated, Seattle attorney James Gooding said Thursday.   “They were shocked and didn’t know what had happened. They had never seen anything like that,” Gooding said. “No one at Everett Rehab did anything or told anybody about his condition. We believe it was negligence. They didn’t care.”   The state Department of Social and Health Services later cited the home for failing to provide adequate care to the man.   An administrator at the care center on Thursday declined to discuss the allegations. She cited federal privacy laws about health care.   “I assure you however, quality care of our residents is our utmost priority. We deliver care as ordered by (the) residents’ physicians, in accordance with the care plan designated for each resident,” facility administrator Elizabeth Loyet said in a written statement. “I want to assure the Everett community that our team of caring staff remains committed to providing ethical care and quality of life for residents we proudly serve.”   The man went to the nursing home in 2004. His wife had become sick and needed around-the-clock care. He moved into the center to be with his wife, Gooding said. She died a short time later but the man decided to remain at the home.   He was lucid and spoke with his son during weekly visits, Gooding said.   A nurse on Nov. 7, 2007, told the home’s residential care manager that the man had a wound on his penis, records show. The manager went on a three-week vacation and when she returned she forgot about the nurse’s report, according to an investigation conducted by the state Department of Social and Health Services.   She said she didn’t hear anything more about the man’s wound until a doctor at the hospital called on March 14, 2008 — four months later — to report that the man’s penis was gone and instead he had a gaping wound, records show.   Nursing home records document that staff changed the man’s diaper daily and provided him weekly baths between November 2007 and March 13, 2008, according to the lawsuit.   Before he died, the elderly man spoke with state investigators. He recounted telling nursing home staff about a wound to his genitals two months before he was rushed to the hospital.   “They definitely should have seen it. There was no documentation that his penis was beginning to fall off,” Gooding said. “We believe they chose not to put it in the records.”   The man lost 20 pounds and his son finally insisted that he be taken to the emergency room at Providence Regional Medical Center Everett.   “He was definitely in pain. We don’t know if he complained. They never documented it. We believe he didn’t think that they were going to do anything about it,” Gooding said. “He didn’t just go from having a healthy penis to it falling off one day.”   Nursing home staff told state investigators that the man had a history of refusing baths and assistance with using the toilet. They also said he didn’t allow them to inspect his skin for wounds. He generally only allowed one particular aide on the care center’s staff provide him with intimate assistance, according to state documents.   That aide told investigators he reported the wound to a nurse. The nurse said she saw a 1-centimeter wound about two weeks before the man was hospitalized. She said she told the resident care manager, records show.   The center’s director of nursing concluded that the man’s wound developed because he wouldn’t allow staff to conduct periodic skin assessments, state records show.   Patients have a right to refuse care but nursing homes have an obligation to care for their residents, said Linda Moss, a regional administrator for Residential Care Services, part of DSHS.   “It’s a delicate balance,” she said.   If a patient continues to refuse care, making it impossible for a nursing home to provide adequate care, the home can discharge the patient from the facility, Moss said.   The state determined that the home failed to meet a federal standard for care. The man didn’t receive timely medical attention and the facility failed to notify his family or his doctor of changes in his health, the state determined. The care center also should have reported that the man was refusing to allow staff to inspect his genitals.   Administrators at the facility were required to submit a plan to make sure those problems weren’t repeated. State investigators followed up, and did not find any additional violations, Moss said.   “The intent of the citations is to correct the problem and ensure proper care,” Moss said.   If a care center has repeated citations or fails to correct problems, the state can take enforcement action, such as revoking a home’s license or not allowing new residents, Moss said.   The state has never taken those steps against the Everett Rehabilitation and Care Center, she added.

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