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Family struggles after Ore. medication mistake

Tue, 03/22/2011 - 12:45am
DIANE DIETZAssociated Press

At age 80, it appeared likely that Tom Paul Frentress would live out his days pleasantly. He'd been a hard-working Dairy Queen operator and primary caregiver for his disabled wife for three decades; his parents had both lived into their 90s; he'd never needed cholesterol-lowering drugs.

His chances seemed pretty good.

But Frentress had the misfortune of moving to a troubled assisted-living facility — Briarwood Assisted Living in Springfield — operated by Sunwest Management Corp., which eventually went bankrupt.

One night in October 2009, a sketchily trained medications aide — left on her own to pass out drugs and uncomfortable about the responsibility — gave Frentress another man's medicine, according to a state investigation. The medicine caused his blood pressure to drop sharply and that deprived his brain of oxygen, medical records collected by the state show.

He would never be the same.

"He didn't know where he was, who he was, what year it was. He couldn't feed himself. He couldn't walk," his son, Jay Frentress, said.

Since the incident, Frentress has lived at the Green Valley Rehabilitation Health Center in Eugene, where aides help dress and feed him, except on days when his son or daughter arrives to spoon his lunch into his mouth.

"My dad probably lost anywhere from six to 10 years out of his life," Jay Frentress said.

The Frentresses' story is a sad coda to Sunwest's rise and fall. The Salem company became a national player in senior housing during the 2000s, growing from 20 assisted-living facilities to 287 facilities across 37 states.

At its peak, 25,000 seniors depended on the company for housing and care.

But Sunwest's fall has been rapid. Since 2008, Sunwest CEO Jon Harder has been forced out, the company went bankrupt, it was dismantled and sold in pieces to recoup money for thousands of investors and banks the company owed.

The Frentress children say they've been lost in the dust of the collapse. Nobody from Sunwest called to explain or apologize for the harm to their father, Jay Frentress said.

Instead, the company raised his mother's rent at Briarwood by $600 a month to $4,827, because Tom Frentress was no longer there to care for his wife, Jay Frentress said.

"It was a slap in the face," he said.

Who's responsible?

Frentress said he's never sued anybody and really doesn't believe in it, but nobody at Briarwood or Sunwest would take responsibility for what had happened to his father.

Frentress said he told the administrator at Briarwood that he expected the company to pay for the hospitalization necessary after his father was given the wrong medications.

"She said, 'Don't worry. Medicare will take care of it,'?" Jay Frentress recalled. "I said, 'Medicare didn't make the mistake; your insurance will cover it.' She said, 'No, Medicare will take care of it.'

"If this is the industry norm, could you imagine the billions a year that taxpayers pay for mistakes?"

A lot was going wrong at Briarwood in the years that Frentress' father and mother lived there.

Sunwest was taking a 49 percent profit from the facilities' monthly revenue, said an expert witness in one of the dozens of lawsuits filed against Sunwest. The industry norm is more like 35 percent.

Briarwood skimped on food, spending 3.73 cents per day, compared with the industry median of 5.52 cents, according to court records.

Frentress said his father lost 30 pounds. "His bones were starting to show," he said. Frentress and his sister, Cindy Peterson, brought in jerky and cheeses and Costco muffins to try to build their father back up.

Briarwood was later fined $300 after state surveyors discovered a resident had lost 37 pounds in two months without arousing concern from the staff.

But it was medications management that became the major worry at Briarwood under Sunwest ownership.

Hundreds of doses of Vicodin, OxyContin, Darvocet and morphine were allegedly stolen from residents' rooms between August 2007 and 2008, according to a dozen reports filed with Springfield police. An administrator was fired in connection with the thefts.

In January 2009, an aide was fired after a cup full of narcotics from a resident's bedside went missing, a state investigator found.

In March 2009, a resident's guardian moved the resident out of Briarwood because the staff began giving the resident Haldol, a powerful anti-psychotic drug, without first notifying the guardian, state reports show. The state didn't fault the assisted-living facility, however, because the staff had obtained a doctor's order for the drug.

In October 2009, the medications aides — who pass out drugs at meals and at bedtime — seemed pretty mixed up, Jay Frentress said.

One time the tray with medications in cups for all the residents got knocked over and the pills scattered on the floor. The aide picked them up, Frentress said, saying: "Thank God I know where everybody's pills go," Frentress remembers. "Then she puts them back in the trays off of the floor."

The aide who gave Tom Frentress the wrong drugs told the investigator she didn't know that she was supposed to match the prescription to the name on the door, or the protocol of saying the resident's name as she handed him the drugs, the investigator's notes show.

She gave Frentress two hypertensive medications. She realized her mistake immediately afterward, and the staff began monitoring Frentress' blood pressure. It fell to 65 over 40. His pulse was 52.

An MRI later showed brain damage, according to the investigator's report.

The state fined Sunwest $400 for violating state law and causing "serious" harm to Frentress.

People often ask if fines of a few hundred dollars are proportional when a resident suffers serious harm or dies, said Diana Norton, community-based care manager with Oregon Seniors and People with Disabilities.

At the time of Frentress' injury, however, the state Legislature had capped fines that regulators could levy at $500 per incident, Norton said. The Legislature has since raised the cap for the most serious cases to $2,500.

Jay Frentress hired Eugene attorney Tina Stupasky to compel Sunwest to at least reimburse the family for the extra costs they incurred because of the mistake that harmed his father, he said. The family was out $66,000, he said.

Steven Stradley, who was the vice president of risk and administrative services at Sunwest, told her that Frentress would have to get in line with all the investors, lenders, vendors and others seeking payment in the Sunwest bankruptcy, Stupasky said.

She said the company pressured her to settle quickly and suggested there would be no more than $20,000 in compensation available. "Our claim was worth way more than that, so we didn't do it even though we were told we might not get anything," Stupasky said.

What Stradley didn't explain was that Sunwest was self-insured through a captive insurer, Encore Indemnity Management, that was in the Cayman Islands, she said.

"We were told there was up to $1 million available, once the judge got involved," Stupasky said.

Sunwest's headquarters in Salem closed in December; no forwarding number for Stradley was available. Sunwest receiver Michael Grassmueck did not return multiple calls seeking comment.

Stupasky said she can't disclose the final settlement because of confidentiality orders. Jay Frentress said he signed the papers in February.

"By the time we had the settlement, the lawyers got theirs, Medicare took theirs. With the out-of-pocket expenses and everything else — maybe we broke even, maybe we didn't," Frentress said.

In the years since Sunwest's collapse, state regulators have stepped up their periodic inspections of assisted-living communities. Some buildings used to go many years without a look, now survey teams arrive unannounced every two years, Norton said.

"We've worked very, very hard over the last 15 months, and we've turned that around," she said.

Other companies, meanwhile, have taken over Sunwest's holdings.

In 2010, New York-based Blackstone Group investors and Seattle-based Emeritus Corp. senior housing company paid $1.3 billion for 150 Sunwest properties, including four centers in Eugene-Springfield: Briarwood, Woodside, Alpine Springs and Alpine Court.

Emeritus has installed its own systems at the old Sunwest facilities.

"We have strict fire safety procedures that includes several things we're adamant about: No open flames or matches in the community, no cooking in the room," said Maggi Broggel, vice president for quality services for Emeritus' western division. "We've also upgraded the fire panels, the extinguishers, the smoke alarms and the designated smoking areas.

"We have comprehensive training, policies and procedures in place regarding medication management," she said.

Unlike Sunwest, Emeritus provides a nurse each day — including weekends — who closely monitors patient medications, Broggel said.

"I'm definitely sorry about what happened to these folks," she said. "I can't speak to the particulars, not knowing the cases, but we're on our way to a very successful regulatory process in Oregon. The state is very happy with us."

___

Information from: The Register-Guard, http://www.registerguard.com

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