Erma Ufolla's daughters thought the worst was over after they won the battle to move their mother from a wing at the Atrium I Nursing & Rehabilitation Center, where they'd been unhappy with the quality and quantity of her care.
Then they saw the sores.
Two days after Ufolla, then 88 and suffering from Alzheimer's disease and diabetes, was transferred from Atrium's skilled-nursing unit to its personal care unit, aides summoned two of her daughters to the shower room. Moments later, the outraged women emerged to buy a single-use camera, then photographed the inflamed crimson lesions that covered Ufolla's thighs, buttocks and groin.
"We were absolutely horrified," said Janet Taylor of Moon, one of Ufolla's five daughters.
The daughters say those sores, which left scars, erupted after their mother sat for much of a 24-hour period in garments that were heavily soiled with urine and excrement. They said their mother also contracted an eye infection when her hands became contaminated with feces and food.
That incident prompted Ufolla's daughter, Elizabeth Slain of Banksville, to file a complaint with the state Health Department in April 2000, contending that Atrium's patient care, staffing levels and hygiene were inadequate. That complaint mirrors criticisms raised by eight other families who, in recent weeks, have spoken with the Pittsburgh Post-Gazette about their experiences with Atrium at various times since it opened six years ago.
Atrium administrator Martha Fenchak Bell denies those allegations, saying staffing at Atrium is more than adequate and comprises caring, talented workers who are devoted to their patients. "We're a family here," she said, adding that complaints often came from families who were unrealistic or angry about their relatives' dementia.
Bell did not dispute that Ufolla developed sores, but denied that she was allowed to remain soiled for a day or even hours. She said workers might have let her stay that way briefly, however, because Ufolla could balk or become combative.
"You don't want them to [become agitated and] have a heart attack or a stroke," she said.
In Ufolla's case, the Health Department determined that staffing met or exceeded minimum state requirements. An inspector saw workers encouraging her to eat and did not find her wet or soiled.
The inspector also found that another resident -- the late Jeanne Penrod of Bellevue, whose family also had filed a complaint -- had been lying in urine-soaked linens for three hours, and that the home had not turned Penrod periodically ; failed to keep a dressing on her pressure sore; and did not obtain dermatology care prescribed for a facial rash. State records show that Atrium pledged to correct those deficiencies.
Ufolla moved into Atrium's personal care unit April 28, 1997.
Initially, her family was so happy with her adjustment that they kept her there even after she was molested by another patient.
Slain said she and her sisters had had a staff member photograph what appeared to be bite marks on their mother's body. But they said nothing was done until Sept. 17, 1997, when Slain walked into Ufolla's room and found a male patient abusing her.
Robinson police were called and the man was briefly committed to a psychiatric facility. He later was moved out of Atrium. Bell said she had been in a difficult position because she couldn't restrict the male patient's rights without proof that he'd behaved inappropriately.
On March 22, 2000, Ufolla was hospitalized for a urinary tract infection and discharged to Atrium's skilled nursing unit.
In the 18 days before Ufolla returned to personal care, Taylor and Slain said aides also let her sit all night in a wheelchair rather than put her to bed. On April 5, 2000, Taylor said, she found her mother wearing the soiled, soaked sweat suit she'd had on the day before, her hands caked with food and feces.
Bell questioned why Ufolla's family did not move her elsewhere if they were unhappy. She suggested that the family "maybe had an ulterior motive" and was trying to obtain a financial settlement.
Slain and Taylor said they kept Ufolla at Atrium because they could not find a vacancy in another facility they liked and were loath to upset the routine that is important to an Alzheimer's patient. Slain acknowledged that she filed an unsuccessful claim with Atrium's insurance carrier, but said she wanted only "maybe a couple of months knocked off her bill.
"If I was after money, I would've sued."
By last summer, the sisters said, they were on another facility's waiting list when their mother died Oct. 15.
