State regulators in April cited an Anniston nursing home for allowing an employee to continue work after a patient accused him of sexual abuse, a Star review of local inspections finds.

Nearly 50 surveyors with the Alabama Department of Public Health inspect the state’s 230 nursing homes at least every 15 months.

On the inspectors’ checklists are 1,500 things nursing home staff can get wrong, ranging from physical abuse to failing to sit while feeding a patient. The Star looked at the 2015 and 2016 inspections for the five Calhoun County nursing homes inspected by the state.

Few of the deficiencies found at Calhoun County nursing homes in 2015 and 2016 put patients in immediate jeopardy, though. Inspectors cited one home for failing to place a privacy bag on urine bag. At another, a dietary worker’s hoop-style earrings were resting outside her hairnet in violation of state regulations.

At Anniston’s Beckwood Manor on March 3, according to records, a patient called the facility’s administrator at home and accused Beckwood’s assistant director of nursing of molesting the patient. Reports do not show the patient’s gender.   

Administrators ordered the employee to have no contact with the patient and to stay on a different hall of the facility. The employee instead went into the patient’s room. He told state inspectors that he was “just shocked” at the accusation and wanted to ask the patient if something was wrong. The patient told inspectors that the employee cursed at the patient.

The administrators also failed to report the crime to police. They told inspectors that the patient insisted the incident not be reported to law enforcement.

The accused employee, who had been hospitalized on March 28, was suspended on April 6, then fired on April 8. The facility on April 12 brought in a consultant to train staff on proper policies for responding to abuse.  

Dr. Walter Geary, director of the Bureau of health Provider Standards for the state health department, said that one of the steps nursing homes must take when dealing with an accusation of staff abuse is to ensure all residents are protected from the potential abuse.

“We interpret that fairly strictly,” he said.

Moving someone accused of abuse to another hall fails to protect all patients, he said.

Geary said incidents like the one at Beckwood Manor are uncommon among Alabama’s nursing homes. He estimated that the department deals with about three or four such cases a year.

“We have many more instances of sexual interaction between residents than we do of sexual abuse by staff,” he said.

According to Geary, about 80 percent of elder abuse, neglect and exploitation happens to those not living in a licensed residential health care facility such as a nursing home or assisted living facility.

Cases outside of health care facilities are typically investigated by a county’s Department of Human Resources. At a public forum on elder abuse in June, Calhoun County DHR director Sam Smith said the department received 334 reports of elder abuse. Of those, 111 turned out to be true.

He said the department hires staff to investigate elder abuse based on need, and it has gone from one caseworker to four.

Beckwood also dealt with an accusation of sexual abuse in 2004. With that incident, administrators told an employee accused of touching a patient on the thigh to stay away from the resident. State inspectors, who later stepped in to investigate, seem to have cleared the staffer of any wrongdoing.

Beckwood Manor also fired an employee in 2010 for verbal abuse of a patient, but only after state inspectors intervened.

When reached by phone, Beckwood Manor director Clayton Cox referred questions to the facility’s owner. The Star’s efforts to reach the owner were unsuccessful.

Cox told The Star in 2014 that the staff welcomes the inspections and wants to resolve any issue found.

John Matson, communications director for the Alabama Nursing Home Association, said nursing homes are the third most regulated industry in the United States, behind airlines and nuclear power.

Matson said the inspection can often be difficult, but they also help caregivers perform to the best of their abilities.

“We are constantly under the microscope; however, in a lot of ways we appreciate that,” he said.

Summaries of deficiencies found at five Calhoun County nursing homes during 2015 and 2016

NHC Healthcare

  • Staff failed to ensure a patient’s data set reflected a discontinuation of an indwelling catheter.
  • Staff failed to note the discontinuation of a Foley catheter in a patient’s data set.
  • Staff had an incorrect birth date listed for a patient in some records.
  • A nurse failed to change gloves after providing incontinent care, before touching clean linens.
  • A housekeeper failed to transport clean linens by holding them away from her body.
  • A nurse failed to sit down while feeding a patient. Inspectors consider this a dignity issue.
  • The nursing unit manager failed to post the nurse staff schedule.

Jacksonville Health and Rehabilitation

  • Staff failed to document meal and snack intakes for three patients.
  • Staff failed to ensure a resident’s catheter bag was placed in a privacy bag.
  • A nurse failed to use soap during incontinent care for a patient.
  • Staff failed to ensure that patients’ oxygen concentrators had filters and that those filters were clear of dust. This affected 10 patients.
  • A nurse failed to wipe a patient properly during incontinent care.
  • Staff moved a patient while wearing soiled gloves.

Piedmont Health Care Center

  • Staff failed to note on a patient’s data set that he or she was receiving hospice care.
  • Staff failed to ensure a resident with a history of weight loss received an ordered supplement.
  • Staff failed to ensure that a container of food was properly sealed and other containers were stored too close to the floor, which could attract bugs.

Golden Living Center in Oxford

  • Staff failed to ensure fixtures in patients’ rooms were in good condition. The deficiencies included a drawer missing a handle, broken vents in an air conditioning unit, a hole in a wall, a cracked light fixture and blinds for a window were broken. The deficiencies affected six patients.
  • During an inspection, staff failed to place a hand roll in a patient’s right hand to prevent pressure sores.
  • Staff failed to collect a patient’s uric acid and magnesium levels.
  • A staff member placed a wash bottle in the wrong place while providing incontinent care.
  • While providing incontinent care, a staff member failed to change gloves after handling soiled washcloths and before touching a clean brief  
  • State inspectors made two separate investigations into complaints and found the nursing home was in compliance with health standard requirements.

Beckwood Manor

  • Staff failed to insure a post-fall investigation was conducted after a patient fell.
  • Staff failed to ensure that a patient’s nebulizer machine was free of an accumulation.
  • A dietary staff member’s earnings were not contained in a hairnet, and staff failed to check temperatures of food before serving.
  • Staff failed to label an open date and an expiration date on opened vials of insulin. This affected three patients.
  • Staff did not wear gloves while giving an injection, placed soiled linens on a patient’s floor and failed to wash hands after removing soiled gloves. This affected three patients.
  • Staff failed to document a description of a patient’s wound.
  • Staff failed to notify a patient’s physician concerning a significant weight loss (23 pounds or 16 percent).
  • Staff failed to check an abuse registry before hiring three employees. There’s no indication that the employees were reported for abuse, however.

Assistant Metro Editor Daniel Gaddy: 256-235-3560. On Twitter @DGaddy_Star.

I'm the assistant metro editor for The Anniston Star. I edit, post online stories and write the occasional story.