Home Nursing job ‘Crawling on her:’ Austin family sues nursing home after ant bites detailed in condition report

‘Crawling on her:’ Austin family sues nursing home after ant bites detailed in condition report

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AUSTIN (KXAN) — Photos of Kathleen Laurel line the kitchen counter at her daughter’s home: Snapshots of weddings, dinner parties and a “parents’ weekend” celebration from when her two daughters were students at the University of Texas.

These daughters, Lisa Howard and Kelly Pesek, remember their mother as a woman with a sense of humor and quick wit.

“She was so funny and always made us laugh,” Pesek said. “We were all kinds of friends once my sister and I were growing up.”

A photo of Kathleen Laurel and her two daughters at a UT Parents Weekend event. The sisters say memories like these are precious, after losing their mother last fall. (Photo KXAN/Mariano Garza)

Her husband, Joe Laurel, describes her as his “best friend”.

Along with the happy memories, however, are the more difficult ones: his diagnosis of Alzheimer’s, the progression of his disease and an eventual move to a skilled nursing facility in southwest Austin. The most difficult memories to process, according to his family, are those of his last days.

Two weeks before Kathleen died last September, the family said they learned ants were found in her bedroom at Brush Country Nursing and Rehabilitation – and on her body.

“I went there as soon as I found out that day, and I actually spoke to the nurse who found her the night before. This sweet nurse was pregnant and she was crying. She would tell me the story that she was the one taking my mother’s ants away, and she was getting bitten doing it,” Howard said.

The family took pictures of what they believed to be ant bites on Kathleen’s arms and legs. Both sisters told KXAN that they were told by the facility’s management that the injuries resulted from a rash.

“Which looks ridiculous to me, if you see the pictures,” Pesek said. “Then the heat rash begs the question, ‘Well, why – where was she in such heat that she got a heat rash?’ “”

“It’s something out of a horror story,” Howard said.

There are other cases involving ants in nursing homes, including a lawsuit filed last spring in Arkansas about a woman who died after a stroke and a recent report of a Fort Worth area facility fined for ant infestation.

Kathleen’s family has filed a civil lawsuit against Brush Country Nursing and Rehabilitation and the healthcare company that owns it, Dynasty Healthcare Management.

KXAN contacted the company and the law firm representing them. Lawyers for the facility and the company told KXAN they could not comment on the pending court case, but filed a response in Travis County District Court denying all of the company’s claims. family and demanding proof of their allegations of neglect. Their filing also notes that “there is insufficient factual argument to state a claim of gross negligence against these defendants.”

Surveyor’s report

The incident is detailed in a report completed by a surveyor with the Texas Health and Human Services Commission, who was on hand at the nursing facility for an unrelated visit. The attorney representing Kathleen’s family obtained the report and provided a copy to KXAN investigators, who verified its validity with HHSC.

The report says the facility failed to ensure that a resident “with severe physical and cognitive impairments was monitored as needed throughout the night shift, as she was found with active ants crawling on her while she was in bed with ant bites all over her body pain, red marks and hives requiring immediate medical intervention and treatment.

The report cites an interview with a nurse’s aide who told the investigator that she had tried to knock all the ants off the resident before moving her to the bedroom recliner, but that “it was impossible to check on every resident every two hours.”

According to the facility administrator’s interview in the report, he contacted pest control after the incident to “spray inside and outside his room.” Additionally, he said his room was “deeply cleaned” by the housekeeping staff.

The report also noted that the facility’s administrator and director of nursing checked all resident rooms and that “no additional ants” were found. The report also states that the facility has implemented “skin assessments.”

Other workers cited in the investigator’s report detailed other issues they said were caused by staffing shortages: resident falls, missed meals and failure to deliver certain medications on time.

A registered nurse told the investigator, “the lack of care that residents receive due to the lack of staff[ed] was heartbreaking.

Statewide staff shortage

Industry leaders and long-term care advocates have warned of widespread staffing shortages at Texas nursing homes, but also nationwide, in recent months.

“It’s not a new issue. It’s not a, ‘Oh by the way, look what COVID has caused.’ We were tens of thousands of employees behind even before COVID hit,” said Kevin Warren, president and CEO of the Texas Health Care Association, representing skilled nursing facilities.

Last fall, her association partnered with a group called LeadingAge Texas to conduct a survey focused on the workforce in long-term care facilities, including nursing homes and living communities. assisted. They found that nearly every facility in Texas reported Certified Nursing Assistant, or CNA, vacancies. Others had unfilled registered nurse positions, as well as open dietary and housekeeping staff positions.

Seventy percent of survey respondents said they couldn’t compete with other employers.

Warren testified before lawmakers in late June about what he hopes will be long-term solutions: Loan forgiveness programs for people going to work in long-term care facilities, more outreach to high school students. or early college training programs and more funding to offer better pay.

“How do we encourage those men and women who see long-term care as an option to say, ‘It’s affordable. It’s something I want to do and make a career out of it,” Warren said.

Other witnesses told the Texas House Social Services Committee they would also like to see higher salaries for staff, possibly in the form of longevity allowances or retention bonuses.

The state’s long-term care ombudsman, Patty Ducayet, told stories of residents having to wait for a bath or getting out of bed, poorly maintained HVAC systems affecting quality of life for staff and residents, and facility vehicles in poor condition – instead of used for resident activities and appointments.

Lawmakers agreed, saying “most” of the funding “should go to patient care.” Ducayet called for more transparent financial reporting by facility owners and operators to ensure this happens.

KXAN investigators asked Warren about this proposal, and he said he thinks the nursing home industry is more transparent than many other healthcare sectors when it comes to staffing, finances and quality of care.

He said one thing was clear: “there is a significant delta between the cost of care and what [Medicaid] refund is.

In the HHSC investigator’s report into what was found at Brush Country Nursing and Rehabilitation, the facility’s administrator detailed its normal staffing schedule, which included three nurses, five CNAs and three medical assistants. during the day shift. The administrator also detailed the night staff at the facility, which included three nurses and four CNAs.

The report reads: “He said he believed there were enough staff to be able to care for all residents appropriately.”

“Unable to ask for help”

The HHSC investigator’s report details at least four deficiencies found at the facility, including those described as quality of care, sufficient nursing staff, medication errors and the physical environment. The report notes that the facility resolved all deficiencies in just a few days.

Kathleen Laurel’s family said they saw her condition worsen in the days that followed, and 19 days later she died. His death certificate does not cite ant bites or mention injuries seen on his body. His cause of death was listed as “Alzheimer’s disease.”

Howard called the loss of a parent “heartbreaking” but said it was even harder to find out those details of his last weeks alive, “after the fact”.

“She was completely helpless. Like I said, she was non-verbal. She couldn’t ask for help. She had no way to raise her hand and say, “I need help; I am mistreated; I’m hungry; I have ants on me,” Howard said.

Joe Laurel said that in general, he would like to see minimum staffing standards enforced across the state, to ensure people with similar diagnoses at any facility will receive appropriate care.

Pesek added, “To make sure this doesn’t happen to anyone else.”