Should you have a problem with your local hospital, nursing home, hospice, home health agency, boarding care home or supervised living facility, a state agency called the Office of Health Facility Complaints stands ready to take your call. And it helpfully posts records of complaints and investigations online.

To get a flavor of the kind of information available, I searched for all facilities with resolved complaints since July 1. The search returned information about 53 complaints about 49 providers. Of those, 10 complaints were listed as “substantiated,” 16 were listed as “inconclusive” and the remainder were “unsubstantiated.”

Among the “substantiated” complaints: theft of $47 from a resident’s purse at Augustana Home Health Care Service in Minneapolis; a stolen laptop with personal and medical information about two patients of Hennepin Home Health Care Inc., based in Brooklyn Park. Both cases were resolved without violations being issued.

“Safety Hazards”: A client of Alterra Sterling House IGH in Inver Grove Heights suffered a head injury after a fall. Resolved without violations.

“Medication Administration”: A nurse for Rem Health Inc. in Edina arrives late on “multiple occasions” to a client’s home to help with administering medication. “As a result, the client has gone without some of her medications.” Resolved without violations.

“Nursing Care”: Some clients at Elderwood of Hinckley go up to four days without their prescribed medications because staff lets refill orders lag. “Also, incontinence products are no re-ordered in a timely manner and clients have to go without them. Call lights are not always answered promptly and, as a result, some clients have become incontinent.” Resolved without violations.

“Nursing Care”: A resident of Presbyterian Homes of Bloomington summons staff to say her leg is hurting where a pacemaker was recently inserted. The staff member gives her Tylenol but doesn’t “assess the resident’s leg.” Later, the resident calls a family member, who then calls in the woman’s physician. The physician asks that 911 be called and the resident is taken to the hospital for emergency surgery. Resolved without violations.

The longest investigation report in the past month is also the most serious, involving the death of a care center resident who never got the proper emergency medical care, according to the July 18 report by Debora Vangsness, R.N., Special Investigator:

“Neglect”: A resident of Prairie Manor Care Center in Blooming Prairie had three episodes of vomiting and “his condition deteriorated through the morning of 041/18/08,” but the nurse did not “send the resident for a medical evaluation until approximately 1:00 p.m.” The nurse then left the room to summon an ambulance, and then the resident suffered a cardiac arrest. “Although the resident was a ‘full code,’ CPR was not initiated by the nurse.” The resident died before the ambulance arrived.

The investigation determined that the nurse, who was unidentified, was busy with calling 911 and “paperwork” instead of trying to revive the resident. She acknowledged that she had never performed CPR before. The investigation noted that the facility took “corrective action,” including changing its emergency procedures and protocols and the “re-education” of the nurse, who has been practicing for 33 years.

The investigation found that the nurse “is responsible for the neglect.” The office did a random audit of five other medical records to “evaluate the appropriateness of nursing follow up in response to resident change in condition. No concerns were noted.”

In conclusion, “No deficiencies were noted” on the part of the Prairie Manor Care Center.

I give credit to the Minnesota Department of Health for making these reports available. They go significantly further than many regulatory agencies that deal with activities that have much fewer privacy protections than health care.

“We did it to be transparent, not because of any particular requirement,” John Stieger, a spokesman for the Minnesota Department of Health, told me by e-mail.

Here’s the site where you can file a complaint about a health facility. Or you can call (651) 201-4201 or toll free 1-800-369-7994.

This entry was posted on Monday, August 4th, 2008 at 3:28 pm and is filed under How to blow the whistle, Public records. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.