More than 18 months ago, the management of the Hamptons Center for Rehabilitation and Nursing in Southampton Village said the facility was addressing conditions that led to a patient complaint rate 10 times the national average. But concern, and even anger, about the facility’s quality of care persist.
Overworked and understaffed nurses are joined by a long list of former patients, employees and local doctors who continue to level damning allegations about the 280-bed nursing and rehabilitation facility, which opened in 2006. Mired in controversy throughout its history—starting with lawsuits over the construction of the project in the first place, followed by legal problems and financial complications that delayed construction for more than two years—the nursing home originally known as Payton Lane has had a tumultuous three years of business.
The latest criticism of the facility, which is owned and operated by a local limited liability company, North Sea Associates, comes from emergency medical technicians and crews of local volunteer ambulance companies. In a letter to the State Department of Health, they registered concern about conditions at the hospital and complained that calls from the facility have taxed the local volunteer companies.
But even before the EMTs’ complaints, conditions and the quality of care at the nursing home have been targeted by a wide range of local residents and medical personnel, including doctors who have worked with or at the center since it opened. State officials inspecting the facility have reported the employment of people previously found guilty of abuse, and dangerous conditions for some patients. A recent inspection by state officials in November showed improvement, and no new problems, suggesting that the facility might finally be on track. But the number of complaints and issues raised in the first three years of the Hamptons Center’s existence is notable.
Following several months of investigation, The Press tried over several weeks to contact representatives of the facility, and Dr. Charles Guida of Southampton, its medical director. Numerous telephone messages were not returned, and other attempts to obtain comment in person from any facility spokesperson regarding the complaints, both official and anecdotal, were unsuccessful.
According to the state Department of Health, the Hamptons Rehab Center has logged more than 10 times the statewide average of complaints per 100 beds. In April 2008, the facility was cited by state health inspectors for 57 deficiencies in response to complaints filed over the previous three years. That computes to an average of 245.5 complaints per 100 occupied beds—the statewide average during the same time period was 23.5 complaints per 100 occupied beds.
The problems cited ranged from minor issues with food quality and obstructions in hallways to severe deficiencies in patient care and well-being, serious enough to be considered evidence of “substandard quality of care.”
A summary of the deficiencies on the Department of Health’s website, nyhealth.gov, showed that inspectors rated three conditions at the Hamptons Rehab Center at the most grave level of severity: those which pose “immediate jeopardy” to the health of patients—described as the presence of accident hazards, the employment of people who have previously been found guilty of abuse, and a failure to “effectively obtain the highest practicable well-being.” The most severe concerns were also rated as “widespread” within the facility.
The employment of people guilty of abuse and the accident hazards were further labeled as evidence of “substandard quality of care,” which, according to the department, “indicates a systemic deficiency in quality of care within a facility. Only citations related to the quality of residents’ care can have this designation … In addition, for a citation to receive this designation, the deficiency must be severe and/or impact several residents.”
An inspection report posted this month on the department’s website, covering the last three years of inspections, shows a total of 55 deficiencies, including 37 related to a standard inspection of the health care provided by the facility, and 18 to life safety code violations, which include fire codes and other matters. All of the figures are more than double the statewide average for a single facility. Seven of the deficiencies, or more than one in 10, were related to actual harm or immediate jeopardy; the state average is one such deficiency, making up 4 percent of the total at any facility.
Four more complaints listed in the state report were given the second most severe rating by inspectors—defined as causing “actual harm”—including a complaint that a patient was not provided sufficient fluids.
Department of Health spokeswoman Claire Pospisil notes that the summary says two of the conditions were to be corrected by the date of the April inspection and the third was to have been corrected by June 20 of last year. She added that a November inspection showed that the Hamptons Center staff had addressed the issues raised in April, and no new deficiencies were found.
Nursing homes are typically inspected once every nine to 18 months, Ms. Pospisil said, but because of the unusually high number of complaints at the Hamptons Center, the facility is inspected more frequently.
Restricting Food, Water
Dehydration among patients at the facility has, specifically, been a common complaint by residents’ families since early on in the nursing home’s operations, according to interviews conducted by The Press. At least one patient’s death has been blamed by family members on dehydration.
A former employee of the Hamptons Center said in an interview in January that limiting fluid intake was an unwritten policy among nurses so that the diapers of some elderly patients would not have to be changed so often.
“Drinks were delivered but were intentionally left farther away from the beds so [patients] couldn’t reach them,” said Donna Balchunas, a former recreation therapy assistant at the Hamptons Center. “The nurses didn’t want to change diapers, and if the elderly people couldn’t reach it they wouldn’t drink it, and they wouldn’t have to go to the bathroom.”
Ms. Balchunas—who had previously worked for three years at a nursing home nearby operated by Southampton Hospital, which closed when the Hamptons Center opened in 2006—said she frequently complained to the Hamptons Center management about a variety of shortcomings, particularly the lack of attentiveness to hydration and bedsores. She said she quit in early 2007 out of frustration with the lack of action taken to address her complaints.
“Nobody was taking care of anybody,” she said. “People were being sent to the hospital with dehydration and bedsores, and I would tell the directors what was going on, I would tell the advocate, but nothing would get done.”
A Family’s Anger
Ms. Balchunas’s account of the deficiencies in care echo allegations by patients and family members.
Nancy Josselyn, whose mother, Ann Bubka, stayed at the Hamptons Center for two weeks in April 2008, said that throughout her mother’s stay at the center, where she was sent to recover from surgery, the care was poor, particularly when it came to hydration and nourishment.
Ms. Bubka was rushed from the center to Southampton Hospital in early May suffering from malnutrition, Ms. Josselyn said. She claims the nursing report said that her mother had refused food for four days, and also claimed that her mother was given an anti-depressant that her doctor had expressly ordered she not be given.
The family transferred Ms. Bubka to the Westhampton Care Center when she was discharged from the hospital, but she died a few weeks later.
“In my mind, they killed my mother,” Ms. Josselyn, who lives in Massachusetts, said, her voice choking with tears. “She had a minor operation, went there for rehabilitation, and they sent her back to the hospital not having eaten in four days. At 91, that was it for her. I should have packed her up that first day and taken her out of there.”
Ms. Josselyn said that her mother’s stay did happen to coincide with the April inspection of the facility by State Department of Health officials, and that the level of attentiveness by the staff on that day changed drastically.
“What a difference,” she said. “They were running around to everybody, and the food was good, and they were giving back rubs. Then, the next day, once the state people were gone, it was back to the same old thing. You couldn’t find a nurse.”
Her brother, East Hampton resident Bob Bubka, said that it appeared the nurses that worked at the facility were skilled but spread too thin and working too many hours at a stretch—a situation exacerbated, he said, by the fact that most told him they live as far as two hours to the west of Southampton.
Ms. Josselyn said she had consulted an attorney about suing the nursing home but was told her mother’s age and the somewhat vague accusations about the care she received would make a lawsuit difficult to support. She later decided not to file a complaint with the State Department of Health.
A Patient Speaks
Maureen Fallon, a retired registered nurse who stayed at the Hamptons Center in July while she recovered from knee surgery, gave two interviews while she was a patient at the nursing home in which she outlined a long list of problems, headlined by a shortage of nurses that led to an overworked staff putting in marathon shifts, jeopardizing patients’ health.
The former nurse said that nurses at the facility told her that a single nurse is commonly responsible for the care of as many as 40 patients. She said that during her stay nurses regularly worked 16-hour double shifts. She said one nurse, who was five months pregnant, was the only nurse on duty in a wing of 40 patients and worked for more than 16 hours on one shift.
“It is not a weekend thing or a Fourth of July thing—this is every day, every night,” Ms. Fallon said of the understaffing issue. “Some patients take as many as nine medications at a time, which can be a risky proposition for a nurse who’s worked far too many hours to keep track of.”
Ms. Fallon said that the nurses are skilled but do not dare stand up to department supervisors who schedule them, presumably at the behest of facility administration, to work the long shifts without needed assistance.
Ms. Pospisil said the state does not regulate a specific ratio of nurses to patients or how many hours a nurse can work in a given time period, only that the care they are giving is adequate.
Ms. Fallon had a variety of other complaints, about the care, about the conditions—she claims to have spotted roaches on several occasions—and about the food.
But despite her pledges to file a complaint after her discharge, Ms. Fallon, who left the facility days after her interview in July, never filed an official complaint. She said she had numerous health problems since and simply never got around to it. This week, though, she said, “I wouldn’t go back there, and I told everyone I know to stay away.”
Mark Miller, director of the New York State Office of Long-Term Care Ombudsmen, said that a disturbing number of complaints about the Hamptons Center have come through his office as well in the three years has been open. Mr. Miller, whose organization maintains on-site ombudsmen to field concerns and complaints from nursing home and rehabilitation center residents and patients, said that the Hamptons Center currently rates only one star out of five on a Medicare facility evaluation, and that his organization investigated 54 complaints at the facility in 2008—some of them routine, some urgently serious.
The ombudsman program typically follows up on complaints to make sure the facility is addressing them and often will work jointly with facility managers and the resident who complained to address an issue.
He said that of the 54 complaints filed through the ombudsman program last year, 49 were reported to have been satisfactorily addressed. The remaining five, judged the most serious, had been partially addressed but some facet of the issues lingered.
“Combining this with the one star, I would say they’ve clearly got some problems there still,” Mr. Miller said. “Some complaints are tougher than others, but when you’ve got very serious failings—like failing to provide sufficient fluid intake to residents—that are coming up repeatedly, it is a bad sign.”
Families are not alone in their complaints about the facility.
Dr. Allen Fein, a former staff doctor at the Hamptons Rehab Center, said that he has stopped sending any of his patients to the facility until he sees evidence that the quality of care has improved greatly.
In an interview earlier this month, he noted that the facility has some very good employees, nurses in particular, and he has faith that the new medical director, Dr. Charles Guida, will improve the level of care. Still, he said, the nursing home currently is not up to snuff.
“When you have a number of complaints that is 10 times the national average, there is clearly something wrong,” Dr. Fein said. “Things like bed sores, dehydration—these are not the kinds of things they should be behind on. It’s not like we’re reinventing how to prevent bed sores.”
Dr. Fein said that the most frustrating thing about the conditions at the Hamptons Center is the juxtaposition with the expectations local doctors had when it opened. The doctors anticipated top-quality care from day one. “It’s a beautiful facility—it should have been a model home,” Dr. Fein said.
Dr. Fein said that his experiences at the nursing home, where he had been on staff since 2006, were not all bad. He said that when he was caring for patients there he found the medical care staff to be enthusiastic and open to advice from doctors. Harsh criticisms leveled at the nursing home by some other local doctors, including accusations that poor care had led directly to the deaths of patients, are not accurate, he said.
“I have seen them deal with some very tough patients very well,” he said. “I like the staff very much. I think they are very competent. I thought the were enthusiastic and very open to all the teaching I could give them.”
“I’m trying to be positive—it is essential we get this nursing home up to snuff,” he continued. “Their problems end up in our emergency room, so it’s in everybody’s interest that this nursing home be a good one.”
Staff writers Oliver Peterson and Brendan O’Reilly contributed to this story.