By Lisa Chedekel and Lynne Tuohy
The Hartford Courant
From the Winter 2008 issue of HealthBeat
The Hartford Courant’s series on Haven Healthcare, one of Connecticut’s largest nursing home chains, grew out of our general interest in examining how well the state’s system of oversight of nursing homes was working.
As most reporters know, nursing homes are among the most heavily regulated entities operating in our states, with a wealth of information on their patient care and financial records available for public review. Because millions of taxpayer dollars flow through them every year, they are prime territory for reporters interested in tracking how money is spent – or misspent.
Early on in our research, we saw a number of red flags in the public records that convinced us that Haven, more than other chains, was worthy of a closer look. Health inspection records available for review at the state Department of Public Health and through the federal Centers for Medicare & Medicaid Services showed the chain, which operates 15 nursing homes in Connecticut, had been cited more than 45 times in three years for serious patient-care deficiencies, including instances of dehydration, malnutrition and bed sores that had been neglected for so long that they led to residents’ deaths.
We saw disturbing trends in the data: Some Haven homes had been cited repeatedly for the same violations, paying minimal state or federal fines for the deficiencies, but then cycling back out of compliance. We also examined patient complaint records. Haven became a window through which we could examine how well the state’s oversight of patient care was working.
Oscar Aceituno, who has advanced Alzheimer’s disease, was placed in a Greenwich nursing home managed by Haven Healthcare. His wife, Susana, says the nursing home neglected to watch him and he repeatedly wandered away from the facility, leading to a serious injury. The family has sued Haven, charging negligence.
Photo: Ross Taylor/The Hartford Courant
We did similar research on the financial side, reviewing Haven’s Medicaid cost reports, which are filed annually with states, and its debt history. What we found was that the chain had spiraled deep into debt, with instances in which heat had been shut off or supplies not delivered to some nursing homes because of nonpayment of bills. At the same time, we found litigation against the company’s CEO alleging that he had improperly diverted millions of dollars in corporate proceeds into non-nursing home ventures. Lawsuits filed against Haven proved to be our best resource for highlighting health care issues and cash flow problems. The financial questions, coupled with the patient-care record, became the basis for our three-day series, “No Haven for the Elderly,” published Nov. 18-20, 2007.
The biggest challenge for us was to try to humanize a story that was based largely on inspection reports and financial records – to find the “real people” who had been affected. Residents’ identities are kept secret in state and federal inspection reports. But with some old-fashioned reporting, we were able to track down the families of some residents who had suffered from poor care by matching the dates and circumstances of incidents detailed in the health records with allegations in civil lawsuits filed against the chain.
We also tracked down former residents who were willing to talk about their experiences, and interviewed relatives of those who had died or been seriously impaired as a result of negligent care, adding a heart-wrenching element to the stories. Former and current employees gave us added insights into conditions at the homes, including how they often used their own money to buy the most basic necessities, such as soap and sanitary gloves.
After the first story in the series ran, calls poured into the reporters from employees.
What we learned: Elderly care is an issue of enormous public interest, and the extensive public records on nursing homes are a great vehicle for examining how taxpayer money is spent, and how effective a state’s enforcement efforts are.
Lisa Chedekel and Lynne Tuohy are staff writers at The Hartford Courant. Read the series about Haven Healthcare.
