Nursing home investigation continues

Jan. 25—THOMASVILLE — A nursing home found to have inadequate staffing during a winter storm earlier this month issued a statement Monday defending its operation.

Pine Ridge Health and Rehabilitation Center said the deaths of two residents of the nursing home were mischaracterized in the reports by public officials about what was found there on Jan. 16.

"Our medical director has indicated the deaths were medically unrelated to any staffing issues caused by the winter storm. The families were notified by our staff at the time of death," the statement said.

Staff had begun making arrangements with local funeral homes well before EMS officials arrived, but hazardous road conditions prevented funeral home staff from traveling to Pine Ridge, the statement said.

The N.C. Department of Health and Human Services' Division of Health Service Regulation staff worked on-site at Pine Ridge through last weekend to investigate the facility's compliance with state requirements, NCDHHS Communications Manager Kelly Haight Connor said.

Thomasville Police Department officers went to the nursing home on Pineywood Road the evening of Jan. 16 after receiving reports staff could not be contacted by telephone and had not been seen by some of the facility's residents. Officers found just one licensed practical nurse and two certified nursing assistants were working, inadequate to take care of the 98 patients of the facility, police said. First-responders went to each room to check on the residents. Two residents found to be in critical condition were taken to hospitals in High Point and Thomasville.

Pine Ridge, owned by Principle LTC, said in Monday's statement it is cooperating with investigators and taking steps to ensure such staffing problems don't happen again. The problems were created by the combination of hazardous road conditions and the rampant spread of COVID-19 across North Carolina, the statement said.

N.C. Rep. Larry Potts, R-Davidson, who heads the NCDHHS Joint House Oversight Committee, said that "concern" was not a strong enough word to express his dismay at what happened. Potts said NCDHHS Secretary Kody Kinsley texted him Saturday about the on-site monitoring team.

"With the team on-site monitoring, I would assume that they're going to have all their Ps and Qs in line due to the ramifications of their actions last week," Potts said. "Right now, with the Thomasville Police Department and SBI still investigating, it will eventually be up to the DA to determine what course of action he takes."

Triad-based attorney Elizabeth C. Todd, who focuses on nursing home accountability, said she was horrified but not surprised by the initial reports about Pine Ridge. It is part of a multi-facility organization, once known as Britthaven, that was often a defendant in lawsuits on grounds of being poorly staffed and operated, Todd said. Medicare ranked Pine Ridge at its lowest quality level with only one of five stars, she said.

But what happened highlights a problem that exists across the industry, she said.

"There's a baseline before anyone ever heard of COVID that facilities like this one that are run for profit make the majority of their profit from understaffing the facility," Todd said. "There are regulations that say how many people they have to have in the facility per shift, but that's only a problem if you get caught."

Unfortunately, state inspectors simply don't have the manpower to go in and do the inspections the way they would like, Todd said.

At the same time, the for-profit nursing home system is a powerful lobby to dispute. The ongoing pandemic brought those underlying factors into view at many nursing homes when family members were not allowed to visit residents.

"There were real cracks, real broken places in the system that were shown when family members were locked out of the facilities," Todd said. "What we were seeing was a drastic uptick in malnutrition and dehydration cases, in fall cases, in pressure sore and choking cases. There had never been enough people in the building to take care of residents, but as long as their loved ones were getting into the building you can be sure that their loved one was at least getting one meal a day. Where the breaks were in the system going in, those systems only continued to break down once the families were locked out of the facilities."

Todd said she understood the facilities' effort to keep the virus out by closing their doors to visitors, but she found fault with the system not having enough staff members to take care of residents if family members were no longer available.

"What happens in situations when nursing homes don't have enough staff is the residents die, Todd said.

In May 2020, state lawmakers passed a sweeping COVID relief act that gave health care providers immunity when their actions or inactions were directly affected by COVID.

"It was meant to take some of the pressure off of health care providers if something happened during COVID that wasn't their fault and to allow family members to see residents," Potts said. "COVID spread so fast. We were all learning as we went, but it wasn't the intent to give anybody a blanket pass on their actions. That will be up to the legal system to determine."

cingram@hpenews.com — 336-888-3534 — @HPEcinde

cingram@hpenews.com — 336-888-3534 — @HPEcinde