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thedrifter
01-04-08, 06:14 AM
Denogean : Veterans still not receiving the best care
ANNE T. DENOGEAN
Published: 01.04.2008

Arizona's veterans have served us well, putting their lives on the line to keep our nation safe and free. But is the state serving them as well as they deserve?

That's in question when it comes to the quality of health care being provided to elderly veterans at the Arizona State Veteran Home in Phoenix.
State legislators will demand some answers in upcoming hearings, said Rep. Jonathan Paton, a Tucson Republican.

Paton noted the state is planning a long-term care home for southern Arizona veterans in Tucson. He wants to make sure what happened in Phoenix isn't repeated here.

Over the past 11 months, federal officials have twice imposed multi-thousand-dollar fines on the facility, run by the Arizona Department of Veterans' Services, for providing poor care to its approximately 185 residents.

Those patients are mostly over 70 and served during World War II and the Korean War.

On Feb. 5, inspectors from the Arizona Department of Health Services found patients to be in "immediate jeopardy" because of staff members' slow or no response to call buttons and their failure to properly monitor smokers.

The Associated Press reported that inspectors found patients in soiled bedclothes and unsupervised patients who burned their clothes while smoking.

"If you've got people smoking outdoors who have limited motor or mental ability, the risk for serious burns is very real," Lisa Wynn, deputy assistant director of the licensing division of the department of health, said in an interview this week.

As a result, the federal Center for Medicare and Medicaid Services, which relies on reports from state inspectors, fined the home $10,000, she said. The state imposed another $6,250 in fines.

The Arizona Legislature held hearings and allocated $3.5 million to the veterans' department to improve patient care.

Pat Chorpenning, director of the department, resigned under fire and was replaced by Gregg Maxon, a retired National Guard brigadier general.
Gov. Janet Napolitano - the veterans' department falls under her administration - reassured the public that all necessary actions would be taken to make sure veterans get quality care.

State inspectors returned to the facility in mid-November to do a follow-up inspection and investigate new complaints. They found the call button response and smoker supervision much improved but they uncovered a serious set of new problems that caused "actual harm" to patients," specifically regarding bedsores and falls.

People fall and get pressure sores in nursing homes, but the state facility had inadequate patient care plans to reduce or prevent those events.

One resident fell 18 times in a four-month period, Wynn confirmed.

Injuries suffered by patients included broken hips and facial cuts, she said.
In December, the feds responded by hitting the facility with another $10,000 fine and cutting off its funding for new patients. The state may impose its own fines.

It's not unheard of, but "it is unusual for a facility to have serious problems like this twice in one year," Wynn said.

Dave Hampton, a spokesman for the Department of Veterans' Services, said the department made big changes following the latest inspection.
The director and assistant director of nursing were demoted. Staff re-evaluated all the home's residents for skin issues, fall and fracture risks and for risk of unsafe wandering.

Also, Hampton noted, on Nov. 9, just before the inspection, a highly regarded new home administrator, Susan Bender, came on board.

State health regulators have accepted the facility's plan of corrective action. And, he said, the facility is ready for reinspection, which will come unannounced.

"I'm very confident we'll not see such deficiencies again," Hampton said
State lawmakers are not so confident, having heard similar reassurances nine months ago.

Rep. John Nelson, a Litchfield Park Republican, said he was ticked off when he read the November inspection report.

As head of the House Committee on Counties, Municipalities and Military Affairs, he is planning hearings and may consider the feasibility of an independent oversight committee that would evaluate the state home and report back to the Legislature.

Paton served on the ad hoc committee that conducted last year's hearings and expects to attend the upcoming hearings.

"This is not about getting the governor (a Democrat) or anything like that," he said. "This is about soldiers, sailors, airmen and marines."

The governor welcomes legislative hearings for the sake of transparency, said Jeanine L'Ecuyer, Napolitano's deputy chief of staff.

Napolitano was furious about the results of the November inspection, L'Ecuyer said.

"It should not have happened again. There are some reasons, but they are not valid excuses," L'Ecuyer said.

The governor is confident the facility has the right people and a good correction plan in place, but Napolitano won't be "comfortable" until the facility is trouble-free for a long time, L'Ecuyer said.

Let's be clear. Nobody wants to shut down the veteran home. Revoking the state license and/or Medicare certification would leave the residents without a home, Wynn said.

And the issue of the veterans facility should not become a platform for building or destroying anyone's political career.

But what we have to date is a lot of plans and promises.

Arizona's leaders and officials - Napolitano and Maxon in particular - should consider themselves on notice that the public expects results.
Especially our veterans and their families.

Anne T. Denogean can be reached at 573-4582 and adenogean@tucsoncitizen.com. Address letters to P.O. Box 26767, Tucson, AZ 85726-6767. Her columns run Tuesdays and Fridays.

Ellie