This month reporter Lindsay Tice of the Lewiston Sun Journal wrote about a nursing home in Lewiston that’s on a federal list of problem facilities. Complaints about Marshwood Center in Lewiston allege that patients have suffered from maggot-infested wounds, have been left in beds soiled with urine and feces and sometimes go without food for 14 hours.
Tice spoke with Maine Public host Jennifer Mitchell about the complaints.
Mitchell: Some of the complaints about Marshwood sound severe, so what have some patients been experiencing?
Tice: They are severe, and they’re so severe actually that the state has focused on this facility as a “special focus.” So they say, 'You’re so bad, you guys really need to clean up your act and you need to do it now.'
Some of these problems include folks not having their wounds tended to correctly, care plans not being either made or followed, which means patients aren’t being cared for properly. You’ve got folks without food, you’ve got folks without nutritious food when they need it. A host of problems.
One of the things I ran into repeatedly was folks not having their call bells answered. So these are folks who need help, let’s say going to the bathroom or getting up out of bed. They can’t do it themselves. They’re in a nursing home or rehab facility for a reason. And so when they can’t get them answered, they lay there, and they lay there for sometimes hours. Sometimes they don’t make it to the bathroom, which obviously can be a very big problem for folks.
Maggot-infested wounds. That’s not something that you hear about a lot in a country like the United States. I’m guessing there are quite a few gasps going on around the state right now. How does that come about?
This was in an investigative report. So the state and the feds work together, the state sends in investigators and so this was part of the report that one of those folks wrote up. In this case, a person was in Marshwood, they were a diabetic patient and they had diabetic wounds on their feet. And Marshwood was supposed to take care of it. Apparently they did not, or at least they did not do so properly, because when the patient left they had more wounds than when they went in. One of those wounds according to the spouse had maggots when they got home. The stench was very bad. The spouse was obviously appalled, and the person ended up back in the hospital pretty much immediately.
So Marshwood is not the only facility on this list, there are others, but what makes it stand out compared to other nursing homes?
They’ve got sustained problems. They’ve had problems for a very long time, for what some folks say is years. They’ve got more problems than usual. Every place is going to have some problems. We’re all human, things happen, but they’ve got significant and severe problems and they’ve had them for a long time. And they’ve got multiple issues, you’re not just talking one area. So not just food, not just wound care or not just care plans, but you’ve got multiple, sustained and varying problems.
How are Marshwood’s administrators responding to these kinds of complaints, and what are state and federal regulators doing?
Administrators didn’t respond to us very much. When I did this story, the administrator at Marshwood declined to talk. Marshwood is owned by Genesis HealthCare, which is a national, for-profit company. They issued a statement that said basically, in part, 'We care about our people.' And that was largely it. After my second story that looked more comprehensively at some of the families involved, in the family situations, I got a more all-encompassing statement from Genesis.
The local folks still wouldn’t talk, but Genesis outlined some of the things that they were doing, which was they brought in an outside company to look at wound care. They brought in an outside company to look at ways where they can improve. They’ve gotten a new administrator for Marshwood, things like that. So they say that they’re moving forward.
The state Long-Term Care Ombudsman Program is also working to get a patient family panel there. So these are folks that will gather, will be kind of spokespeople for the families and say to administrators, ‘Hey, we have this issue. We have that issue. What are you guys going to do to take care of it?’ The state has named Marshwood a special focus facility which means they are on this problem list, but they are a big problem even on the problem list, and so they are going to be focused for the next at least couple of years, they’re going to be getting more inspections, more focus on them. If they don’t start improving, there are going to be penalties up to and including at the end of the next two years, potentially the loss of Medicaid and Medicare funding, which for most nursing homes is a large portion of their funding.
What have you heard back from readers? What’s the reaction been?
We’ve been getting a lot of reader responses in emails, social media contacts, phone calls, all from families that are just distraught. Their loved one was in Marshwood at some point or they were in Marshwood at some point, and they have just some very disturbing stories to tell, and all of them have very similar elements of staff not answering call bells, folks being left to languish without care, that kind of thing. And unfortunately, we’re also getting some calls and emails from folks at nursing homes outside of Marshwood so other nursing homes where they say, 'Hey, this is not just there, we’ve got issues elsewhere as well.'
So what’s the takeaway from this? What should people who need nursing home care be thinking about this or taking away from it? What can they do to ensure that they get quality care or or work with a quality facility?
That is really the takeaway, is that you need to do your due diligence, you need to look at the places where you’re going to go and that’s not always possible. Often if you’ve got a loved one and it’s an emergency situation, and there’s a bed open, you’re going to go for that first bed. But the takeaway from this is that if you’ve got time, if you’ve got that luxury, don’t just go for the first open bed.
Take a look at the place, talk with the doctors, talk with your friends and neighbors, anybody who’s had any kind of a relationship at all with a nursing facility or rehab facility to say, ‘What was your experience there? What did you like? What didn’t you like? What concerns you? What should I be aware of?’ Talk with the ombudsman program, that’s what they’re there for. Ask them questions. Sometimes they will even go on tours with you so they point out things and you understand more deeply what you are looking at there. And make sure you tour. You can absolutely stop by, you can take a look around, see if people are dressed, if they are engaged, if call bells are being answered, if people seem distressed or if they seem happy.
If you go at mealtime, which is a great time to go, make sure that people are getting help when they need it to eat, that they have the utensils that they need and the special cups that they need or any other equipment that they need to feed themselves if that’s what they feel like they should be doing. Make sure there’s no significant smells, that there are no significant issues with damage to the walls or to the facility itself. Make sure that you would feel comfortable staying there before you put a loved one there.
This interview has been edited for clarity.
