Former Arc staff
say patients abused

Ex-employees claim
they were mistreated by
management after filing reports

4 Arc homes close
Deficiencies reported

By Rosemarie Bernardo

Former employees of the Arc in Hawaii allege mentally retarded residents were mistreated and that their complaints were ignored by management.


Barbara Ash, a licensed practical nurse who spent six years with Arc, said she was ostracized and mistreated by management and other employees after she had filed reports of patient abuse and neglect to state and federal agencies.

Ash resigned from the nonprofit organization Feb. 1.

At the Diamond Head facility, Ash said she witnessed two employees dragging a mentally retarded person on the ground when she resisted boarding a van for an outing. Ash said she yelled at the employees to stop. Another employee was able to talk to the resident, who eventually boarded the van.

Ash also observed a resident at the Diamond Head facility who suffered burns on her leg and was not taken to the hospital until the next day.

Doctors informed Ash that the resident suffered from second-degree burns. It is unknown how she got the burns, said Ash.

For the first four years she spent at the Arc, Ash said, she received nothing but praise from management on her performance.

After she filed a report with designated state and federal authorities about patient abuse, everything changed, she said. For the next three months, Ash's duties were shifted from working with residents to doing paperwork.

"I felt like I couldn't effectively do my job," she said.

In February, Ash filed a lawsuit against the organization for emotional distress and unlawful threats against an employee for reporting violations of the law.

Interim Executive Director Lambert Wai said, "We don't have supporting evidence. Right now it's in the hands of our lawyer."

Calls made to Arc attorney Richard Philpott were not returned.

Geri Graham, a former Arc nurse practitioner for the Wailua A facility on Kauai, said employees at the care home failed to immediately report that a resident suffered a broken arm. She said she was told about the resident's injury 12 hours later.

Graham cared for five residents at the facility. Like Ash, Graham said management retaliated against her after she raised concerns to management about patient care.

"I was denied access to patients," she said. Graham left the organization in November 2001.

"I was unable to do it anymore," said Graham, now director of nursing at Hawaiian Health Care Professionals on Kauai.

Former employees stressed that a change in administration at the organization is needed to improve facilities and patient care and treatment.

Kim Landreville, who worked at the Diamond Head facility as an instructor for the Arc's day treatment program, said she heard employees verbally threaten the residents.

"'If you don't shut up, I'm going to staple your lips' or 'You're going to come to this outing if I have to drag you by the hair' were some of the threats made to the patients," said Landreville, who spent almost two years with Arc in Hawaii.

Landreville resigned from the organization last June and is now taking classes in the social work program at Chaminade University.

After raising questions with management, Landreville said she received subtle threats of losing her job and did not receive assistance when she asked for more help with clients.

"We have to speak up for those who can't speak up for themselves," Landreville said.


Some of the deficiencies reported
at four ARC facilities in Hawaii

Wailua A facility on Kauai

>> On June 6, 2001, a nurse noted that a client was roughly handled by being forced to walk by staff. She fell and broke her toe.

There was no indication that the incident was reported to the administrator or state agencies such as Adult Protective Services or the state Department of Health as an allegation of abuse.

In the report, the nurse said the client was mishandled and that she injured herself resisting. Staff members are instructed to back off and to try again later if a client is not willing to listen. In her report the nurse stated that she "considered staff 100 percent liable for the injury."

>> Last July 23, spaghetti with meat sauce and salad with fat-free dressing were served for dinner. The menu indicated that salmon, steamed cauliflower, broccoli and carrots were supposed to be served. According to surveyors, the house manager said she could not afford the salmon listed on the menu. She added that she cooked what was on sale and fed clients according to what she had the ingredients to prepare.

Ewa facility on Oahu

>> On April 25, it was reported that the home manager told a nurse that she sometimes tells a resident to hit another resident.

>> On June 4, it was reported at a day program that a client had been sleeping excessively. An agency nurse discovered that someone had administered a psychotropic medication for agitation to the resident daily instead of "as needed" since April 9, 2002.

Management said the home manager was responsible for the error in how often the medication should be administered, and said she was to undergo retraining on medication procedures. But there was no evidence that the retraining had taken place, investigators stated. In July it was discovered that the same home manager was responsible for a medication error for another client.

>> On Oct. 22, surveyors reported that the branch manager of the Pearl City day program said the restrooms were cleaned by the clients.

Dominis facility on Oahu

>> On May 30, 2001, the temperature in the home was recorded at 93.7 degrees by state investigators.

At the same facility, a resident was prescribed Mellaril at bedtime for insomnia. Investigators said there was no consent signed by a legal guardian authorizing the use of Mellaril for sleep.

>> On Oct. 19, 2001, an allegation of nutritional neglect was made claiming that there were only 48 ounces of canned beef stew and three cans of mixed vegetables for dinner for the seven clients at the house.

>> Last July 17, the small bathroom did not have any toilet paper, soap, paper towels or paper cups. A closet in the bathroom containing the items was locked.

>> On July 18 the kitchen was in poor condition. There were dead bugs and a buildup of dirt in the corners, and food, dirt, debris and paper were on the kitchen floor. The refrigerator was dirty on the inside with numerous spills. Ants were crawling inside the microwave.

>> On Jan. 4, 2002, there was an allegation of abuse claiming that a staff member told a resident to shut up and shoved him.

Halawa facility on Oahu

>> Last Oct. 21, clients attended the Wahiawa Day program and performed tasks such as cleaning the restrooms, sweeping and mopping the floors, and removing the trash. None of the clients were paid for the work.

>> On Nov. 13, 2001, a staff member was accused of wrestling a client to the ground and holding him in an "unnecessary restraint." Investigators reported that the client suffered red marks around his shoulders and neck and a possible toe fracture.

Eyewitnesses said they heard the staff member become agitated after the client had bumped into him while he was trying to get to a classroom. After being placed on administrative leave, the staff member was allowed to return to work as long as he attended training on abuse and neglect and completed an anger management course. He was later transferred to the Wailua A home in Kauai.

Further investigation revealed that the facility failed to report the results of all investigations of the incident within five working days.

Compiled by Rosemarie Bernardo

Centers for Medicare and Medicaid Services
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