Scranton Veterans Home Cited, Fined

By Walter F. Roche Jr.

A state run nursing home for veterans, with a history of rules violations, has been cited by the state Health Department and fined $11,375 after a patient was injured at the hands of an employee who  then tried to cover up the incident.
The attempted cover up was one of several violations cited in a 43-page inspection report on the Gino J. Merli Veterans Center in Scranton recently made public. When the facility was inspected in September, it  was already operating under a provisional license due to prior violations.
Other violations turned up in the two day inspection include failure to ensure that a patient did not develop bed sores and failure to properly investigate and report multiple thefts from residents.
Joan Nissley, spokeswoman for the state Department of Military and Veterans Affairs said that all the deficiencies have since been corrected and state health officials, on a return visit, agreed. She also said a new commandant has been named to oversee the facility operations.
"As we work through this transition, we continue to closely monitor the situation at Gino Merli to ensure that we are providing Pennsylvania veterans and their spouses with long-term services in a safe secure and caring environment," Nissley wrote in response to questions.

 According to the report, a patient suffering from Multiple Sclerosis and "totally dependent" on at least two aides to get in or out of bed, was injured while a single attendant tried to return him to bed.
Though records indicate a lift was required to move the patient, the attendant attempted to lift him by hand.
The patient's leg was gashed on the bed frame, the report states, and the patient had to be brought to an emergency room for eight stitches to close the wound.
Initially a second aide told facility officials that she had assisted in the transfer. Later, however, after the patient was interviewed a second time, the female aide admitted she was not on hand and had lied to cover for her colleague.
"The resident firmly stated only one male nurse aide was present during the incident on April 23," the report states.
 Nissley said the two employees had been terminated.
In a plan of correction filed with the state, Merli officials said they would establish a monitoring system to ensure that patients were transferred in and out of beds according to the physicians' orders.
The inspectors also found discrepancies in the records for another patient who was discovered to have "newly hatched larvae" in a wound on the left ankle.
Though the larvae and wound on the ankle were noted on Sept. 3, the records showed that it wasn't until Sept. 8 that another entry was made showing the requested treatment had been provided five days earlier.
The inspectors said that the director of nursing "failed to provide an explanation" for the discrepancy.
Nissley said that health officials later found that the proper treatment was implemented and the patient has since recovered.
The review of records showed two cases in which residents who were free of pressure sores on admission developed sores while under the center's care.
One of those patients, who was diagnosed with dementia, developed a pressure sore on his abdomen, apparently from a hand splint. The inspectors concluded that the failure to monitor the patient resulted in "actual harm."
"It is the goal of the facility," the report states, "that residents will not develop bed sores."
The center's plan of correction calls for re-education programs for staffers on the avoidance and treatment of bed sores
 The repeated thefts at the facility, inspectors found, occurred over a five month period. Though there were 11 thefts during that period, only four were reported to the state as required.
Citing a meeting with residents, the report states there were "continued and repeated complaints of misappropriation of resident monies within the facility."
The money went missing, the report states, even though many of the residents said they kept their cash in locked boxes.
In its corrective action plan, the facility said the patient who registered the initial complaint was reimbursed for the $15 that was taken. Staff also will be re-educated on the proper procedure for handling theft complaints.
In yet another citation, the inspectors found two patients were not getting prescribed devices or medications. A resident with diabetes, the records showed, was not given insulin as prescribed by the treating physician.
Also noted were unsanitary conditions including a hallway permeated "with a strong urine-like odor."
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