SOUNDING THE ALARM: NURSING HOME SECURITY POSES PROBLEM FOR FAMILIES, PATIENTS

Bob Hente counted on a Cape Girardeau nursing home to care for his aging mother.

But on the morning of June 26, his mother, Veneda Allison, walked out of the Beverly Health and Rehabilitation Services nursing home at 2852 Independence.

Once outside, she fell on the pavement near the front entrance ramp and suffered serious head and facial injuries.

"She broke all of her facial bones," said Hente. She also broke two ribs and suffered an injury to her brain.

"She can't maintain her balance anymore," Hente said. "She can't walk on her own." All of her food has to be pureed.

Hente said he is amazed she didn't die from all her injuries.

She was hospitalized for two weeks before being moved from Southeast Missouri Hospital to another nursing home.

The Missouri Division of Aging investigated the incident and found that an outside door alarm had been turned off.

"From our perspective that facility was responsible," said Paul Shumate, deputy director of the Division of Aging.

But the agency didn't fine the nursing home even though a similar situation occurred with another patient at the facility in 1995.

The nursing home agreed to improve its monitoring of patients and see to it that all staff members are properly trained on setting the door alarms.

Hente contends that Beverly Health and Rehabilitation Services was negligent in caring for his mother, who suffers from Alzheimer's.

"I really feel like they were very much at fault because they didn't maintain the security they said they would do," he said.

Hente, who lives in Cape Girardeau, is suing the nursing home on behalf of his mother.

The suit seeks to recover medical costs associated with the treatment of the woman, as well as punitive damages.

David Snyder, the nursing home's administrator, wouldn't comment on the lawsuit.

A spokesman for Beverly's corporate office in Fort Smith, Ark., also refused to comment on the lawsuit.

But the spokesman, Jeff Amann, said a 1997 survey showed the Cape Girardeau facility has a good approval rating with families of the nursing home's residents.

Amann said the nursing home is "in full compliance" with government regulations.

Beverly operates more than 600 nursing homes in 31 states, including 29 in Missouri.

Beverly has operated the Cape Girardeau nursing home since it opened in 1982. The facility has 120 beds, including 30 in its Alzheimer's unit.

Hente said staff at the Cape Girardeau nursing home left his mother unattended in the facility's west wing around 6:30 a.m. on June 26.

She was found outside on the ground at 7 a.m. by a housekeeping supervisor.

The lawyer for Hente and Allison, Michael Ponder of Cape Girardeau, said the nursing home was negligent.

"They were negligent in failing to have an adequate alarm system should an escape occur," Ponder said.

Nursing home staff also failed to adequately watch Allison to see that she didn't escape, he said.

Allison had lived at the nursing home since 1989, except for about a year when she lived in a Jackson nursing home.

Ponder said the 85-year-old woman had a history of trying to leave the Cape Girardeau nursing home.

She tried to leave 83 times and managed to actually escape 10 times, including the most recent incident in June, Ponder said.

Allison had been placed in the Alzheimer's unit in recent years, which is a more secure wing of the nursing home.

But after frequent falls, she was moved earlier this year to the less-secure west wing for medical reasons.

Ponder said patients with Alzheimer's typically wander. The nursing home staff should have known better than to leave Allison unattended, he said.

Ponder suggested the Division of Aging should punish nursing homes that put patients at risk.

"I am concerned that nursing homes are not being held accountable for repeated violations," he said.

But Shumate defended the agency's actions.

"The system is more remedial than punitive," said Shumate, "but we do have the authority to fine."

Shumate said fines are levied against nursing homes that have a history of repeated violations.

The agency also imposes fines to force nursing homes to take immediate action to correct serious problems, he said.

Nursing homes can be subject to both state and federal fines.

The division rarely shuts down a nursing home for violations. "Communities aren't anxious to lose their nursing homes. They just want the problems fixed," said Shumate.

The Division of Aging also inspects nursing homes for federal violations.

Since the federal regulations were implemented in July 1995, fines totaling $386,915 have been levied against 13 facilities.

Shumate said nursing homes face a challenge in caring for wandering residents.

"You want a humane and as home-like a living environment as possible," he said. On the other hand, the facilities must look out for the safety of the residents, many of whom suffer from some form of dementia.

"It is a challenge to balance those things out," he said.