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Creekside attorney James Geary says Creekside was unexceptional. "It was probably no better, and no worse," he says, "than any other nursing home." Except that Creekside is paying for its lack of care. Bessie Seday, for example, collected a $862,500 settlement last December stemming from the infected bedsores she contracted while living at Creekside.
Rhoda Johnson, Ila Swan's mother, lived at Creekside nearly two years, until July 1993. Her family alleged in a lawsuit that the nursing home essentially abandoned Johnson: she was often left lying in her own waste, hungry, cold, unfed and unturned. One day she complained to Swan that her hip hurt. With her sons' help, Swan lifted her mother out of the bed, pulled up her nightgown and collapsed in sobs. "She had this bedsore on her hip that was so deep," her daughter recalls, "that I could see the hip socket and leg bone moving inside the hole." Her bottom was bruised and caked with dried feces, which Swan peeled off with her fingers amid her tears. "I never had looked under the covers," she says. "I didn't think I had to." Johnson, now 98 and living in a Utah nursing home, doesn't talk much about her experience. "Creekside was mean to me," she says. "They didn't give me a drink, they yelled at me, they hurt me." She received a $775,000 settlement in May 1996.
Creekside owner Richard Schachten, who trained and spent his early years as an undertaker, disputes any suggestion that neglect was endemic. "The quality of care was very good," says Schachten, who sold the business in 1995. "I have not paid one dime in fines, there's never been an admission of guilt, and the facility's license was never revoked or suspended."
Implicit in Schachten's defense is the presumption that the government keeps a keen eye on nursing homes. A decade ago, Congress passed a major nursing-home reform bill, which did help to cut down on the use of physical restraints and tranquilizers. But in 1995 a quarter of the nation's nursing homes failed even to assess each patient's needs or develop individual care plans, federal records show. Even more failed to ensure sanitary food, and about 1 in 5 didn't provide proper treatment for bedsores.
That year the Federal Government got the power to punish nursing homes in ways other than denying them federal funds. The government can now levy fines, deny payments for new patients to nursing homes and mandate training for their staffs. Yet the government seems mighty miserly when it comes to holding nursing homes accountable.
In the past year nearly 10,000 of the 15,000 nursing homes inspected by the states had violations, and many were forwarded to federal officials with proposed punishments. But fines or other penalties were imposed in only 2% of the cases. State inspectors recommended to U.S. authorities that 5,458 nursing homes--1 in every 3--be barred from collecting money for new patients. Washington cut that figure to 156. The states urged Washington to order special training for the staffs in 3,039 nursing homes; Washington ordered such training for only 103. And state inspectors urged Washington to fine 2,935 nursing homes for violations. The Federal Government fined only 228 (and those that paid without appealing had to pay only 65% of the fine).