Citing a litany of neglect, incompetence and the untimely and painful death of one resident, the Department of Social and Health Services has revoked the license of an Adult Family Home at 2949 25th Ave. W.
The home is one of seven operated by New Beginnings Family Homes of Seattle Inc., but Erik Burgess is the company representative who hires the staff at the seven homes and is listed as the provider in the Feb. 11 license-revocation notice. The notice is a follow-up to a damning investigative report completed by DSHS on Feb. 6.
Burgess has indicated he intends to appeal the notice, said Pat Jennings, a DSHS regional administrator for residential-care services.
In the meantime, she said, the home is still operating, although no new residents can be admitted to the facility. Technically, DSHS can shut down an Adult Family Home with 72-hours notice, but that doesn't seem necessary in this instance, according to Jennings.
However, DSHS staff will be checking on the home. "We do have a procedure for unannounced visits when we do a revocation," Jennings said.
At the same time, the unannounced visits won't be for the purpose of seeing how much things have improved for the residents of the home, she said. "We have told those [residents'] families we want the home closed."
There appears to be ample reason.
Based on a complaint, the DSHS inspected the Magnolia home last Dec. 6, 9 and 28, and again on Feb. 5 and 6 this year. Among the findings, one elderly woman was admitted to the hospital last Nov. 2 suffering from pneu-monia and dehydration after being sick and becoming progressively worse for seven to 10 days, according to the report.
"I wish someone would have come and checked on me at least once," the woman told a DSHS investigator. "I had pneumonia. I was deathly ill. I couldn't breathe."
The woman had no way to call for help because the resident manager lived in a different part of the house, and the resident did not have an intercom or buzzer she could use at night when the resident manager was asleep, according to the investigation.
The woman also suffered from diarrhea, which stained the carpet in her room and left an odor "so bad that it was difficult to stay in the room for more than a couple of minutes," according to one DSHS investigator.
Yet the resident manager did not keep a medication log indicating prescribed Immodium was ever given to the woman to treat the condition, and the resident manager mistakenly gave the woman two different kinds of blood-pressure medication when the resident should have been taking only one, according to the investigation.
The DSHS report adds that another elderly woman at the home suffered an injury that left her with an eye swollen shut after she fell down on Dec. 5 in a room without carpet and may have injured herself on one of many nails sticking up out of the floor.
The floors were sticky and smelled of urine in the rooms of two men who lived in the home, and the resident manager told DSHS that in one case the room was mopped "every couple of days," according to the investigation.
Also putting the residents at risk, according to the investigation, was the resident manager's live-in boyfriend, a man allegedly responsible for at least six incidents of domestic violence in the home since October 2003. The latest incident took place on Nov. 30, when he allegedly injured his girlfriend and was arrested.
Yet Burgess at first denied to DSHS that he had any knowledge of domestic violence in the home, according to the investigation, which adds he then said: "There were no convictions."
An untimely death
But the most troubling evidence found in the investigation involved 89-year-old Helen Nichols, a resident in the home who was admitted in January 2004 and died there on Nov. 27.
The cause of death was listed as senile dementia, but her doctor told DSHS the woman would have been expected to live another year or two under normal circumstances.
According to the report, she became bedridden last June and had developed five bed sores by Nov. 21 because staff at the home had not been turning and repositioning the woman in bed with the use of pillows. That was despite an Oct. 12 hospice report that said she needed to be turned every two hours.
One of the bed sores was so bad it may have reached the bone, according to the investigation, which adds that the woman "was only turned for 4-8 days before she died."
That she was repositioned even that much may have been because of the intercession of a registered nurse and owner of another Adult Family Home in Magnolia. The woman, who spoke only on condition of anonymity, said Nichols' nephew, Kalman Brauner, had contacted her about moving his aunt into her home.
"He asked me to check on her," the woman added. "They obviously weren't turning her at all." The woman went on to say there were no pillows in the room and that a staff member at the home had to hunt for them.
The report notes that Brauner hired an outside agency on Nov. 21 to provide extra help for Nichols "since the facility was not providing the care." The extra care included feeding her on a regular basis, according to the investigation.
The DSHS report indicates that Nichols had dropped from 160 pounds when she was admitted to the home to 110 pounds by Sept. 29. Yet records at the home showed the woman was eating all her meals three times a day, according to the report, which noted that staff at the home could not explain how the woman lost so much weight if she was eating so well.
Nichols also spent the last 10 months of her life in needless pain, some of it severe, because staff at the home did not give her prescribed doses of pain medication, according to the investigation.
Burgess did not return a call for comment, but he told both daily papers that the problems DSHS spoke of were overblown. So did Nichols' nephew for that matter.
The other Adult Family Home owner contacted by the nephew disagreed. "This is a big fat mess," she said. "Here's all these defects, and they're still operating."
Louise Ryan, a state long-term care ombudsman, is also amazed that the New Beginnings home is still up and running. Jennings at DSHS said the resident manager has been fired, which Ryan believes is a step in the right direction.
But Ryan still questions why the home has been allowed to continue
operating. "I think they're taking a risk going with this approach," she said. For one thing, Ryan added, Burgess runs three other Adult
Family Homes in Snohomish County, and two of those had their licenses revoked on Dec. 20. "That's a pretty clear record to me," she said.
DSHS records show the three Snohomish County homes are owned by Erik Burgess and Angela Burgess, who are operating as Puget Sound Care Homes LLC.
Charges pending?
The Adult Family Home operator contacted by Nichols' nephew said she gave police a deposition as part of an investigation of the New Beginnings home in Magnolia.
The case has been referred to the King County Prosecutor's Office, said spokesman Dan Donohoe. "There's not been a criminal charge filed yet," he said, adding that could take a while.
Donohoe declined to say what charge or charges might be filed against the New Beginnings home. "I don't think we can really speculate right now until we review the information the police sent."
Staff reporter Russ Zabel can be reached at rzabel@nwlink.com or 461-1309.[[In-content Ad]]
