Monday, June 17, 2024

Repeating history? CMS investigating death at NHRMC, complainant speaks out

WILMINGTON — Novant Health is under scrutiny again after a patient’s family member flagged multiple issues at New Hanover Regional Medical Center. (Port City Daily/file photo)

WILMINGTON — Novant Health is under scrutiny again after a patient’s family member flagged multiple issues at New Hanover Regional Medical Center. 

READ MORE: Fed report confirms Novant’s insufficient staffing, nurses detail to PCD problem extends beyond ER

The Centers for Medicare and Medicaid, the federal agency charged with overseeing medical facility compliance standards in order to participate in the programs, is looking into the death of an 80-year-old woman. The inquiry comes almost one year after the hospital was in “immediate jeopardy” of losing its Medicare contract. 

The agency has yet to confirm the investigation with PCD. However, the patient’s son filed a complaint following his mother’s passing and told PCD on Thursday the agency informed him of an investigation into his mother’s two visits to the ER, 24 hours apart.

Port City Daily spoke with the husband and son of the deceased patient who requested anonymity due to the unresolved case against Novant. Therefore, in this article, the husband will be referred to as Dale, the son Lucas, and their deceased wife and mother, Lena. 

Despite his mother’s age and a couple of well-managed conditions, Lucas told PCD his mother was in very good health and had never really spent any time in the hospital. 

“My mom was brilliant,” Lucas said. “She was a super smart lady. Her body wasn’t the greatest, but her mind was spot on.” 

So the family knew something was wrong when Lena began acting confused one night. Dale described her speech as jumbled and she was mistaking certain household items for others. After she fell, they called an ambulance, which carried her to NHRMC. 

“If I knew what I knew now, I would have gotten her in the car and driven right down to Duke Hospital,” Lucas said. 

Once at New Hanover Regional Medical Center, he said his mother was seen pretty quickly and that the ER waiting room was not very full. However, he said patients were on beds in the hallway — including his mother. 

The nurses focused on Lena’s broken wrist caused by her fall. 

“But my mom’s broken her wrist probably 10 times — she played volleyball,” Lucas said. “We explained the issues going on: We think there’s something going on mentally — they need to test that.” 

But Lucas said the only care his mother received was a mangled wrap of her wrist — the nurse “was basically letting the wrist flap around” — performed by a nurse, who then told the family Lena was ready to be released. When Lucas asked to see his mother’s chart, he was told he could view it online in Lena’s patient portal. Her son said they never spoke to a doctor and Lena’s mental state was never addressed. 

At 2 a.m. the next morning, Lucas got a call from his dad.

“She’s down on the floor, we can’t even pick her up because she’s so busy screaming because if you have an infection, you’re sensitive to touch,” Lucas said. 

EMS delivered Lena to NHRMC again, where doctors determined she had a serious infection. She was admitted to the seventh floor, where they received the best care, according to Lucas. But when she was moved to the 10th floor, “everything turned south again.” 

While Lucas and Dale noted the hospital was short-staffed everywhere within their view, it was very apparent on the 10th floor. Lucas claimed all the staff were primarily traveling nurses who regularly showed up an hour late to their shifts due to being moved to different floors at the last minute or trying to navigate a new facility. 

According to Lucas and Dale, they would call for nurses and no one would come, sometimes leaving Lena’s bedpan unattended for hours. She would also request a family member to be present when she was being moved by nurse aides. 

“I’ve never seen so many aggressive nursing assistants,” Lucas said. 

On her fourth night on the 10th floor, Lena’s condition rapidly declined. Doctors located an internal bleed behind her kidney and eventually determined it would be fatal. Even as the family thought Lena’s suffering was coming to end, Lucas said she was further degraded when a staff member barged into the hospital room as the family was making their goodbyes. The man, wearing a lab coat but otherwise was not identified by Lucas, questioned their decision to have an autopsy done to determine what led to Lena’s death. 

“I wanted to grab that guy,” Lucas said. “That guy should be fired. Nobody deserves that. He does not need to be in a position to be talking to people in that condition ever.” 

Dale and Lucas submitted their experience to Novant’s patient advocacy department, but Dale said he was sent a letter saying the hospital found no one was out of compliance with its policies. 

Lucas, having retired from the medical device business and worked in hospitals across the state, said he had never experienced a hospital like NHRMC. Despite Novant’s claims of being fully staffed as of February, Lucas attributed his mother’s lack of sufficient care due to the understaffing of experienced nurses that knew the facility. 

Several nurses detailed the same problem to PCD last year after CMS found violations in multiple categories, including patients’ rights, nursing services and emergency services. The investigation was prompted by the death of a 77-year-old woman who waited over five hours for care in the ER waiting room. 

CMS’s report stated in nine out of 10 cases NHRMC failed to maintain adequate staffing to meet the needs of incoming patients arriving by EMS. It also found in half of cases, staff failed to assess, monitor and evaluate patients to identify and respond to changes in patient conditions.

Novant blamed its problems on the national nursing shortage exacerbated by the Covid-19 pandemic, but months before the investigation, NHRMC had let go of many of its travel nurse contracts. In the months since the facility was restored to compliance, Novant has rehired travel nurses with the caveat that they would not be a large part of NHRMC’s long-term plan. 

The nurses that spoke to PCD in the fall said Novant’s issues stem from understaffing, a problem universal to every hospital they’ve worked at. The difference at Novant, they corroborated — along with the CMS report — was Novant’s management of its employee shortage resulted in overworking staff and putting patients in serious safety risk across many departments, not just the ER. 

Lucas concluded his experience, and others like his, goes beyond staffing problems all the way to the hospital executive’s bottom line. Novant Health and other major healthcare systems in the state made record profits during the pandemic. 

“Vital bonuses are set upon how much money they save in the ER — they go to cheaper products, timelines where I’m out faster — all your bonuses are built upon that kind of system,” Lucas said. “We’re trapped until another hospital, another powerhouse, comes in here and builds another big hospital … you’re gonna have them pay nurses less wages; you’re gonna get the bottom of the barrel on orderlies; you’re gonna get maybe not the cleanest facility because where are we gonna go?”

Still, Lucas, who is planning to sell his Wilmington home, said he was not seeking to gain anything other than for Novant to be held accountable and commit to do better. 

“I want people to know what happened,” Lucas said. “My dad still lives here. Friends live here. My sister and her nieces and stuff live here. I want better health care.”


Reach journalist Brenna Flanagan at brenna@localdailymedia.com 

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