nursing home probed after death

http://www.newsobserver.com/2010/02/17/343957/nursing-home-probed-after-death.html

CHAPEL HILL -- An incident at a Chapel Hill nursing home is being investigated after several patients mysteriously tested positive for opiates, officials said today.

The Britthaven of Chapel Hill nursing home, which has a spotty record of patient care, notified state authorities after one patient's blood tests showed the presence of opiates, despite not being prescribed the narcotic. That patient died of an unrelated bout of pneumonia, said Phillip Hill, vice president of operations for Britthaven, Inc.

But when that patient's blood results came back positive for opiates, nursing home staff grew alarmed. They noted that some other patients in the home's 29-bed Alzheimer's unit showed signs of lethargy, and were also tested. Opiates were found in at least two other patients, who were admitted at UNC Hospitals.

Britthaven then notified authorities, including the Chapel Hill Police Department and the state Department of Health and Human Services, which oversees adult care facilities.

"Obviously if somebody wasn't on the medication that showed up in the bloodstream you want to know how it got there," said Jeff Horton, head of the Division of Health Service Regulation.

Hill said the incident remains perplexing, because no drugs were out of order or missing at the nursing home. He said the police found no evidence that a crime was committed, but the company is continuing its investigation.

"It's real hard to determine what caused a patient to have a positive drug screen," Hill said. "Many types of antibiotics can give a false positive for opiates."

In the meantime, he said, the regular staff of the nursing home's Alzheimer's unit has been temporarily replaced with workers on loan from the corporate offices in Kinston and from other nearby facilities.

"We are reassuring family members that we have a completely new team on this," Hill said, adding that security at the facility has also been ramped up. "Residents are safe."

Britthaven has had regulatory issues in recent years at its Chapel Hill facility, which has 133 beds. Prior to the current incident, the nursing home had been designated a "special focus facility" because of persistently poor care. As a result, Horton said, the facility gets two inspections a year instead of one.

During inspections in 2008 and 2009, the nursing home was found to have subjected some residents to imminent jeopardy by failing to protect them from abuse. Residents got only about half the state average of hour of care by certified nursing assistants. In November, Britthaven paid a federal fine of $7,117.54 for failing to provide enough supervision to prevent accidents to residents.

"It dealt with having safe water temperatures in their patient areas," said Beverly Speroff, with the Division of Health Service Regulation.

Speroff said this afternoon that state inspectors have not yet visited Britthaven. Typically, state inspectors, who work on behalf of the Centers for Medicare and Medicaid Services, collect information on possible violations by observing the nursing home, conducting staff and family interviews, and reviewing medication records. "Generally, we're going to collect as much data on this situation as possible," Speroff said.