Allegheny County's Kane nursing home system started a half-century ago, but rarely has it received the public attention of the past two weeks.
Kane officials quietly spent the past two years following a task force's recommendations to reduce nursing home beds, increase occupancy rates and prepare for alternative long-term-care housing designed to better serve the county's elderly in the 21st century. The four Kane centers avoided any serious criticism of care quality in that time. Though running a deficit, the finances were much better than earlier this decade.
Those stabs at progress, however, have been overshadowed by the Christmas Eve news of the recent arrests and dismissals of five employees accused of abusing a 94-year-old Alzheimer's patient at Kane's Glen Hazel regional center.
The four-story hilltop facility is one of four government-run Kanes spread around the county, and it has a greater focus on dementia care than the others. It also had more quality-of-care concerns than its counterparts in Scott, Ross and McKeesport earlier this decade, receiving state provisional licenses and fines over questionable deaths.
But county officials insist the recent allegations of long-term mistreatment of patient Thelma Bryant by employees who police said struck her, cursed at her and threw oranges at her are no indication of the quality of care now at Glen Hazel or any of the county-owned facilities. The four centers have 1,124 beds. Currently running at 92 percent capacity, they care for more than 1,000 residents at any given time.
"I think Glen Hazel has come a long way in the last couple of years, and now this is a setback," Dennis Biondo, executive director of the Kanes, said, adding he hopes the system does not suffer from any loss of public confidence in it.
"Time will tell," he said. "I'm sure there will be some effect."
The most notorious local nursing home abuse case in the past decade was at the private, nonprofit Ronald Reagan Atrium I Nursing and Rehabilitation Center in Robinson, where an Alzheimer's patient died when wandering into an outdoor courtyard on a cold night in 2001. An extensive investigation ensued after the facility sought to cover up the circumstances of the death.
Employees and families of other residents detailed their own concerns about that understaffed facility, which the state ultimately shut down, with administrator Martha F. Bell imprisoned for federal and state convictions.
If there are any such widespread concerns about the Kane system or Glen Hazel specifically, they have not emerged publicly. Relatives visiting their loved ones at the facility since Christmas have expressed confidence in it, as did Bob Hanlon, a six-year patient who is president of Glen Hazel's residents council.
"No one's mentioned anything else like this occurring," Mr. Hanlon said in an interview last week at the facility, where he has been cared for since suffering a stroke. He said he knew of no similar criticisms of the licensed practical nurse and four nursing aides accused of harming Ms. Bryant, all of whom he knows personally.
"Everybody seems to think things are all right," Mr. Hanlon said from his wheelchair. "They can't expect things to be 100 percent no matter where you're at, unless it's your own home."
The federal government's Centers for Medicare & Medicaid Services last month launched a five-star rating system for nursing homes nationally, in which Glen Hazel received a three-star rating, meaning average quality. The Kane at Scott received five stars, Ross three stars and McKeesport fared worst among Kanes, with two stars.
Mr. Biondo said he could not explain why the perception of Scott would be so much better than the others, other than it has been cited for fewer deficiencies on state surveys. He knows of nothing, he said, to explain that difference on inspections among the four homes that opened in 1983-84. They replaced one massive Kane home that started in Scott in 1958.
"If you walk into McKeesport and walk into Scott, I'm not sure you'd see any difference," he said. "It's the same policies, same procedures, same levels of staffing, same administrative capabilities."
The county does have different plans, however, for the four facilities, which collectively ran a deficit of about $3 million this year that had to be covered by the county's general budget.
It has an agreement with a private developer to construct a 60-unit apartment building on the Ross campus this year. It is the first phase of a project expected to later add more assisted-living or independent-living units, plus an adult day care center.
At the Scott campus, 10 acres of vacant land are being sold for $330,000 for a developer to construct 28 carriage homes. Inside the nursing home, a transitional care unit has opened to specialize in care of short-term patients coming out of hospitals.
And at Glen Hazel, construction is planned this year of a 14-unit facility attached to the nursing home, in which residents will live independently but be able to purchase services such as meals and housekeeping from the nursing home.
To make room for the changes, the county has reduced the size of the Ross nursing home by 120 beds and Glen Hazel by 90 beds since 2006. The state Department of Public Welfare provided $15 million to compensate the county for loss of reimbursements from caring for fewer nursing home patients, while pursuing other long-term care options that are less costly to the government and more desired by consumers.
Kathleen McKenzie, the deputy county manager who was co-chairwoman of the task force reviewing the Kanes two years ago, said the new projects will help the county mirror private-sector, continuum-of-care practices that give elderly residents a range of living options as their needs change.
"People seem to appreciate that we have [the Kanes] here," she said. "We still agree that skilled nursing is something important as a mission of the county ... but this is a real paradigm shift in how we perceive our mission."
Because of the Kane centers' large size, ranging from 210 beds at Glen Hazel to 360 at McKeesport, they are typically visited more frequently than other nursing homes by county ombudsmen monitoring patient issues, according to Kurt Emmerling, bureau chief for advocacy protection and care management for the Allegheny County Area Agency on Aging.
Although no specific records are kept on complaints against the Kanes compared to other facilities, he said they've had no pattern of trouble providing care. Most abuse or neglect complaints reported to the Area Agency on Aging are for situations in people's own homes rather than at facilities, and most are for problems other than physical abuse.
"I was surprised to hear it," Mr. Emmerling said of the abuse allegations. "The Kane systems have been known in the last years for good quality care and I have not heard of other things like this."
Mr. Biondo has declined comment on the specific allegations, citing the ongoing police investigation. He said relatives of Glen Hazel patients have been reached by both letter and telephone about the charges, without any allegations arising from them of additional suspicions of abuse.
It was other staff members, rather than relatives, who reported concerns about mistreatment of Ms. Bryant that dated back months, Mr. Biondo said. He said new information is being distributed to all Kane employees emphasizing they have a duty to report any such concerns about their colleagues' behavior, and they are able to do so anonymously.
A preliminary hearing, originally scheduled for today, has been postponed until Feb. 10 for the four aides accused of assault and neglect of a care-dependent person: Danielle Taylor, 46, of the North Side; Shelly Keene, 35, of West Mifflin; Karen Perry, 46, of Homestead; and Shalaya Hatten, 30, of the Hill District.
The LPN who was supposed to be supervising them, Mary Ann Bower, has a court hearing scheduled Jan. 21 on a summary charge of harassment.
Gary Rotstein can be reached at firstname.lastname@example.org or 412-263-1255.