Abraham Mahshie – Contributing Writer
Early one morning on about Oct. 1, Barbara Bradley was roused from her bed to prepare for breakfast at Macon Valley nursing home when a scream was heard from her room.
The SPARK unit of Macon Valley is a difficult place to work for some. It is a lockdown facility for patients suffering from dementia and Alzheimer’s disease. The memory of some patients is so bad they cannot remember where the bathroom is located in their own room. Sometimes, they ask for food when it is placed in front of them.
Barbara Bradley was known as a sweet old woman. She smiles. She dances. But the wily 74-year-old Haywood native had escaped from Blue Ridge nursing home in Sylva earlier this year. That’s why her family was forced to transfer her to Macon Valley. But in the seven months since moving in, she experienced a rapid decline in health, said her son, David Bradley. Still, he said, that didn’t make her dangerous.
“You have to trust the place where your parents are,” he said. It wasn’t easy for family members to find a lockdown facility in western North Carolina that accepts Medicare and didn’t have a wait list of 6 to 8 months or longer. Macon Valley has space. Bradley lives on the Carolina coast, making it all the more difficult to help his mother.
“That was my only option and we’ve been stuck,” he said. Nonetheless, he recalls, “People said, ‘You need to get her out of there as soon as possible.’”
According to a Sheriff’s office report dated Oct. 11, Certified Nursing Assistant (CNA) Tammy Buckner allegedly screamed at Bradley, jerked her hand off a safety rail, and pushed her down onto the toilet. Bradley was crying, and her body was visibly shaking during the incident, according to the report.
It was also noted that a three-page written statement about the incident from Oct. 1 that was turned into Head Nurse Lindsey Roberts and Administrator Donna Stephens had disappeared. Like all healthcare facilities in the state of North Carolina, Macon Valley is required by law to report within 24 hours any allegation of abuse to the North Carolina Department of Health and Human Services (NCDHHS).
In addition to routine inspections of the nursing homes that it certifies, state inspectors interview staff members to assure the facilities are abiding by federal and state regulations. They also visit to investigate complaints and follow-up to assure corrective measures have been taken. It was during an Oct. 11 visit that state investigators became aware of the alleged abuse and informed authorities. The Sheriff’s Office in turn sent out two detectives and the alleged abuse was reported to the Macon County Department of Social Services.
David Bradley doesn’t think it was an isolated incident.
“It’s scary what’s going on,” he said. “It just so happens someone saw it this time.”
Record of Deficiencies at Macon Valley
Charles Benson Grindstaff was born in Macon County and was a disabled veteran of the U.S. Army. He used a wheelchair because his right leg was missing below the knee, the result of an injury sustained after his service. His final years were troubled, including arrests for indecent exposure and disorderly conduct. By 66, he was known to suffer from alcoholism, pain and had impaired cognitive skills. He needed help with most activities of daily living. He was admitted to Macon Valley Dec. 23, 2017, after a hospitalization, but Grindstaff didn’t behave. He wouldn’t last long.
Grindstaff was a smoker and Macon Valley has a no smoking policy. Residents were not even permitted to smoke in the parking lot. Grindstaff did anyway, violating the policy numerous times. He didn’t follow his care plan either; he just wanted to go home. Macon Valley discharged him “without any assessment, preparation or planning” according to the State of North Carolina. A facility driver dropped the veteran off at a tin utility shack with no running water, no electricity, no toilet or shower and no landline. His living place was acknowledged to be a fire hazard and a later visit by an Adult Protective Services worker discovered trash burning within a foot of the entranceway. Charles Grindstaff died Sept. 8, 2018, at the age of 67 when a fire engulfed his home.
The State of North Carolina followed up on three complaints reported at Macon Valley in 2017, issuing 34 pages of findings and recommendations available for download on the NCDHHS website. Macon Valley’s 2018 recertification on April 13 elicited a 29-page report of deficiencies that included failure to acknowledge food preferences, review care plans and found that medications were left unattended when a nurse was required to monitor that it be taken by the patient. Further deficiencies were found on May 16 and June 20, which detailed Grindstaff’s case as as “Resident #1,” as well as deficiencies in food safety that included maintaining open and expired foods in nutrition refrigerators. By July 17, the State of North Carolina found that Macon Valley had corrected its deficiencies and was in compliance as of July 13, 2018.
But state investigators returned again Oct. 11. That’s when they learned of the alleged abuse of Barbara Bradley. The Division of Health Service Regulation confirmed that it returned to conduct a complaint investigation at Macon Valley on Oct. 23. The report from that visit will be posted online when it is finalized.
Hard to Find Good Help
Nestled in a serene landscape of fall foliage, Grandview Manor at 150 Crisp Street in Franklin also faces the challenge of how to provide the best care for sufferers of dementia.
“Dementia is the biggest care issue,” said Deborah Strum, administrator at the assisted living center. “People with dementia are not giving you a bad time, they are having a bad time. That’s true. It’s really difficult.”
A little under half of Grandview’s residents aged about 60 to 95 suffer from dementia and are housed in a special wing of the facility that is supported by additional staffing.
“It’s a very tough problem. That’s our hardest caregiving issue,” said Strum, and it requires specialized training and a certain type of individual that has become harder to find.
“When hiring becomes difficult, you’re taking risks with people,” she said. “We really try working to get decent employees. It’s a big challenge. You have to work at it.”
Strum said that Grandview Manor takes very seriously its patient’s Bill of Rights and training to prevent abuse and neglect. In her 50 years of association with the facility, she said the state has not found a case of abuse or neglect.
“If we have anything that looks like abuse, we report it,” she said. “The system I think works fairly well in facilities.”
Strum said if an employee, family member or a resident reports an abuse, the facility has 24 hours to report it to the state for investigation.
“It’s hard to get enough workers,” Strum admitted, praising the work of her daughter-in-law, who heads her human resources section. She has no resident nurse on staff and employs about 20 CNAs at about $12-$13 per hour. “They are a valuable commodity.”
The number of beds in the facility is controlled by the state, and Strum said it is a long and complicated process to be certified. The Macon County Department of Social Services visits once per month and the North Carolina Health Department visits about once every two years, she added.
“There is a level of competition in this business. You’re not guaranteed residents. There are options. Residents are not stuck,” said Strum. When her 105-year-old grandmother was in the residence, an assistant approached her to ask her what she should do about her grandmother, who rang her call button and requested a single ice cube. “I said, ‘Well, you know what you do? You take her an ice cube.’ It could be a lot worse.”
Editor’s note: Interviews were requested with Macon Valley’s Head Nurse Lindsey Roberts and Administrator Donna Stephens. Written questions were also submitted in person and via email. Macon Valley didn’t not respond.