Blind Prophecy

So far the visit home has been mostly uneventful. I spent the bulk of yesterday taking my last diagnostic exam (scored 173, I’m kinda awesome) and hanging out with my niece and nephew. I forget how there’s always drama of some kind brewing at home. This weekend has been a near trifecta.

First, my sister Jayne’s family in Iowa is coping with the flooding. Jayne has apparently lost her job because the office she works for is flooded and the lawyer who runs the practice doesn’t see how he’ll be able to keep staff on in the immediate future. Jared is also visiting Jayne, Brian and Alexia this summer. Luckily, their house is on higher ground and probably safe the flooding, but their jobs and neighbors aren’t doing so well.

Second, my sister Jasmine received news last night that the brother of her boyfriend (the guy on his Mormon mission for the next year and 9 months) was killed in a car accident. She was pretty upset, as you can imagine, and I’m sure Chris is taking it very hard, too.

Finally, the family made the front page of the Salt Lake Tribune today. Last time that happened, it was me in the story and it was about Utah Pride. This time, however, there’s a story on the ten worst nursing homes in the state – three of them belong to my uncle’s company. Yup, the good old family business, which has employed more than 50% of my extended and nuclear family at some point in time. Here’s the part where my mother’s family makes us all proud:

Not out of the cellar: No Utah nursing home had more overall violations than Infinia at Granite Hills. The home, which specializes in mental health cases, also had the second-worst record of deficiences where a resident was harmed.

And like Johnson, Infinia owner Scott Robertson lays much of the blame on the residents.

“We take the kind of patients that won’t go anywhere else – the complainers,” he said.

The Disability Law Center agrees that Granite Hills “tends to be the dumping ground.” But Eileen Maloney, an advocate for the center, said if Infinia markets itself as a company that can take care of those tough patients, then it should be able to follow the regulations.

Infinia’s problems, though, stretch far beyond Granite Hills.

Its sister facilities – Infinia at Ogden and Infinia at Alta – also ranked in the 10 worst performing homes in Utah. The company owns two of the worst homes in Arizona and a failing home in Minnesota, according to health departments in those states.

The Alta facility received the most severe deficiency given in the last two years for forcing a woman to take a shower against her will. Robertson replaced the administrator and the director of nursing.

Since then, the new staff has worked to fill in gaps in the medical records of patients and correct accounting errors, Maloney said.

All of the violations have cost Infinia customers and cash.

The Infinia homes have been fined more than $200,000 since 2000. That equals about $4,000 per actual harm deficiency, though the nursing home chain was not fined in every case. Infinia at Granite Hills was fined more than any other home, racking up nearly $139,000 in penalties.

The government set the fine amounts 20 years ago, capping the worst offense at $6,500 if a home doesn’t appeal, though some fines are assessed on a daily basis, adding up until the home fixes the problem.

That’s an inadequate enforcement tool, said Janet Wells, public policy director for the National Citizens’ Coalition for Nursing Home Reform.

“Often it is just the cost of doing business,” she said.

Wells supports a move in Congress that would raise fines as high as $100,000 in the most severe cases.

Infinia’s Robertson says that is ill advised. He thinks the fines as they are now only hurt residents.

“Who suffers because of fines and penalties? It comes out of the money that is supposed to go to patient care,” he said. The state association that represents nursing homes complains that increased fines make it harder for facilities to improve, especially when they are underfunded by Medicaid and Medicare. The association agrees, though, that bad actors should be punished.

Robertson recognizes that his homes have had problems and said his company turned a corner a year and a half ago when a messy business relationship between Scott Robertson and his brother Jon ended.

Jon took control of five Kansas homes, all of which have been labeled low-performers, and Scott Robertson took the 14 other facilities.

Their split followed a bankruptcy, numerous bad inspection reports and a federal audit that determined the brothers failed to adequately staff Infinia at Granite Hills.

Infinia’s problems in many ways were “a central leadership issue,” Scott Robertson said, that started at the top and trickled down to lax administrators and nursing directors.

The problems compounded as a bad reputation drew more scrutiny from the state and the Disability Law Center.

“We have had historical issues with our three Utah facilities, without question,” Robertson said. “But I think we are taking steps to improve the quality of the homes.”

He said he has replaced top people and hired a company* to conduct private inspections to root out problems. He has increased staff. And he is planning to remodel the buildings, which he leases.

He also has much larger changes planned for the future, including selling some of the homes outside of Utah, reducing the number of mental health patients and coming up with a new company name.

Disability Law Center staff may not like every change Infinia has planned, but they say the company has taken their concerns seriously and made improvements.

“There are some positive changes,” said advocate John Inglish. “But by no means would I say they are out of the cellar.”

* Full disclosure: after years of working directly for my uncles, my mom now works for the private company he references – and you can see looking at the charts in the paper that the number of problems have gone down at the facilities her company has worked with since the start of that relationship

Scott and Jon are my uncles on my mother’s side. Grandpa must be so proud to see his son publicly badmouthing another one in the state’s largest newspaper on Father’s Day (although, I don’t think there’s much love lost between Jon and almost anyone else in the family).

I just keep chanting to myself, “don’t specialize in health care law, don’t specialize in medical malpractice law” – although I have a feeling I’d never go hurting for business.

Anyway, I think I’m off to the gym and then a few more practice problems before family starts coming over to celebrate father’s day and the Tony Awards begin.

Filed under: Mi Familia by Jere Keys