Witnesses blast nursing home's management
By Edie Johnson GOSHEN The legislative committee investigating Valley View nursing home listened to damning testimony given by four employees who say its management failed to manage anything neglecting to evaluate employees or communicate with staff, abusing employees, outsourcing work to inferior but more costly service providers, and in one case asking a nurse to falsify a document.
Even though County Executive Edward Diana did not show up (see related article this page), the committee was able to confirm many of their suspicions about why the facility has been struggling financially.
Employees said OAS, the entity charged with managing the nursing home, said theres been a drastic change from when the county's own commissioner ran the facility. In earlier days, they said, staffers and managers met frequently to discuss the goals and strategies that maintained it as a four-star facility.
One employee who had served the facility for 25 years as a senior clerk and in charge of planning and operations said the new management one day ordered her to clear her things out, telling her: "You're in admissions now."
When she got there, she was humiliated to be greeted by Sheriff's deputies, who said she was being criminally charged with disposing of documents improperly. She said she had simply done as she was told, and moved her boxes of stuff out of her office. Trying to get to the bottom of the distressing situation, she went to the Sheriff's office, where she was told there was no charge against her. To this day, she said, no one has explained why she was treated so poorly.
Robin Neidhardt, the facility's nursing director, said employees' hard work has managed to keep the quality of care high. But in recent months, as the county government has discussed selling the nursing home and discontinuing its financial support, there's been a lot of stress at the home, she said.
Last week, the legislature voted to fund the facility at least through the end of the year.
Staffing problems lead to increased expenses
Employees blamed the nursing home's financial decline to poor morale and a cumbersome evaluation system.
Pat Mateo, director of admissions and human services, has worked at Valley View for 23 years. She said best criteria for good care is always a high ratio of qualified staff to patients. After OAS took over, she lost two of the nurses who helped with administrative duties. Last year, 19 employees were laid off. Valley View now has to go through the time-consuming process of getting new hires, and has greater difficulty scheduling the staff they do have.
With rumors abounding about an imminent sale or closure, staff are eager to use up vacation, mental health and sick days, she said. The nursing staff then has to choose from a pool of substitute staff, paid at a higher rate, and fill in vacancies with overtime at an even higher rate.
Legislator Roxanne Donnery, who chairs the special committee, noted that staffers who do not get regular evaluations will be at a disadvantage when they seek other employment.
Mateo said earlier systems of setting policies, procedures, rounds, environmental concerns and general problem-solving "all dissolved" when OAS took over.
"How do you run a facility without goals and objectives and strategies?" she asked. "It's a business."
Outsourcing is also a problem, the employees said, with large sums being paid to outside laundering facilities resulting in a bevy of complaints by patients who claimed their belongings were lost or damaged.
Outside patient evaluation and advertising resources are another waste of money, Mateo said. She had lost one of her best admissions assistants, at a salary far below what is currently being paid, for a service that does not bring in as many admissions as the in-house system had. She also described a nightmare of overlapping evaluation systems required by service providers, who determine which patients and conditions they will pay for.
"Rehabilitation is in now," Mateo said, "This is what they (insurance companies) pay for."
She said nothing is being done to manage reimbursements. Occupancy rates are at about 80 percent, far below the usual 90 to 93 percent. But Valley View has a 130-bed wing for Alzheimer's and dementia patients, diseases with a low rate of reimbursement.
Will Valley View have to accept a larger portion of rehab patients in order to improve reimbursement rates? And if so, what will happen to the growing number of elderly who suffer with Alzheimer's and dementia?
The home has a policy of giving Orange County residents priority acceptance, regardless of their ability to pay.
Management accused of doctoring reports
Neidhardt, the nursing director, said attempts had been made, in her presence, to modify documents to make progress in patient care look better than it really was.
She pointed to an assessment form and said the OAS director, William Poscacello, had told a nurse: "There are too many of those" on the wounds list. He asked the nurse to change the total. The nurse refused.
The committee will continue to meet over the next two weeks. Faced with a raft of problems, they will have to decide which ones they can actually do something about.