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Elder abuse - Reports of nursing home violations are open to the public, but few families consult them

Jean Swanson needed to go to the bathroom, but when the 84-year-old asked for help at her Northeast Portland nursing home, she said staff repeatedly breezed by her room. They told her shed just have to wait.

Swanson, lying in bed recovering from knee-replacement surgery, watched time tick by. One hour passed. Then two hours. Three hours and 20 minutes later, Swanson says, someone finally helped her to the toilet.

"I waited and waited and waited," said Swanson, a concert pianist for decades while raising two children. "It was not good."

A shortage of staff wasnt Swansons only complaint during her 41/2 month stay at Gateway Care and Retirement Center last year. She said an aide tried to give her somebody elses medication and another aide let her fall. The injuries added three months to her stay.

Swanson and her family relied on word of mouth in choosing a nursing home, but if they had checked records available in county or state offices they would have learned that Gateway Care and Retirement Center had a history of citations for neglect or mistreatment of residents.

Only 14 of the 138 nursing homes in Oregon made it through the most recent reporting period without a single citation. And 19 -- including the Gateway nursing home -- had more than a dozen. Few of these lapses made headlines. Most remained buried in the files of state and county inspectors, who make their reports available to the few members of the public who ask for them.

In 2006, the state cited and fined Gateway for dropping another woman -- 60-year-old stroke victim Linda Ober -- breaking both of her legs. She was left in bed for five days before the nursing home sent her to the hospital, where she died the next day. Obers daughter filed a $3.5 million lawsuit against the home last month.

Rick Harding, Gateways administrator, adamantly disputes some details of the lawsuit and says all the deficiencies cited by state inspectors have been addressed. The two aides involved in the incident no longer work at the home.

In a 15-month reporting period ending in November, inspectors cited the Gateway nursing home 13 times for violating federal standards for residents care. Harding conceded last year was unusually bad for his nursing home, but he added that most nursing homes get at least a few violations each year.

Harding is right. Oregon nursing homes averaged six violations during the same period; nationwide it was eight, according to the U.S. Department of Health and Human Services.

Among the cases investigated in Multnomah County:

Inspectors fined the Friendship Health Center in Southeast Portland $3,000 after a patient fell last April while being moved into bed. The patient fell facedown and was bleeding from the head. The patient later died.

Inspectors also faulted the home in another incident last May for failing to call 9-1-1 until 18 minutes after family told staff a patient with hypoglycemia had passed out.

Residents at Care Center East Health and Specialty Care Center in Northeast Portland complained to inspectors about moldy sandwiches, rancid fish and meager servings. A resident who wanted more food was told hed have to wait to see whether there was enough to go around. When he got his extra serving, he complained, it was tiny, cold and "looked like someone had taken a bite out of it."

Other homes throughout the county were cited for a range of problems, including failing to empty a mans catheter after he repeatedly complained, bathing a woman just once in two weeks and failing to encourage a man to go outside. He hadnt been out in more than two years.

Gateway center

Gateway Care and Retirement Center is a cheery place. During a visit last week, a resident played the piano in the recreation area. Another sat on a sofa, gently stroking the homes cat.

However, last years performance put Gateway in the bottom 15 percent of Oregon nursing homes, according to federal records. Harding prefers to highlight the preceding two years: The home had no violations one year and five the next.

Gateway has been fined at least $11,725 since it opened four years ago. Among findings of state investigators:

Caretakers sometimes would falsely tell residents that they were short-staffed to get residents to forgo showers or have their meals in bed.

"Were very proud of the service we give," Harding said, adding that no residents have left the home because of the lawsuit.

The larger picture

The Oregon Department of Human Services inspects every nursing home in Oregon once a year. They also regularly inspect 2,600 other adult-care homes, including residential-care, assisted-living homes and adult-foster homes.

Most complaints, by far, are made about nursing homes: Last year, the DHS fielded 1,660 complaints and substantiated about 500 of them. Investigations can be difficult because dementia or other conditions can make residents poor witnesses. Of substantiated cases, 149 were determined to be outright abuse.

In 2007, three adult-care homes -- Gresham Retirement care facility, St. Ritas Senior Care Community in Salem and Knights Residential Care in Northeast Portland -- closed, either voluntarily or because of state pressure, said Mary Gear, a DHS administrator with the state Office of Licensing and Quality of Care.

Perhaps the most troubled of the three, St. Ritas agreed to close after the state moved to revoke its license for problems including the rape of one resident by another and the phone being answered by a drunken resident.

Gear said state officials have the power to close homes that repeatedly violate standards. But the decision isnt made automatically after a home receives a certain number of violations -- it depends on whether the same, serious problems arise time and again.

"We look at the history," Gear said. "We look back and say Gosh, this is the second or third or fourth time. . . . Weve got a problem. "

Swanson, the 84-year-old who had to wait for hours to be helped to the bathroom, picked the Gateway nursing home because it looked like a pleasant place with private rooms, TVs and phones. The nursing home was a mile from Swansons house, a big plus.

Swanson recovered enough to return home Dec. 24. Her son, Kevin, says if she ever needs to return to a nursing home again, theyll do things differently.

"Wed do a hell of a lot more research," he said.

Aimee Green:503-294-5119; aimeegreen@news.oregonian.com