Hmm. We will be following this story…

(CNN) — Louisiana Attorney General Charles Foti Jr. has issued 73 subpoenas in an investigation into allegations that euthanasia may have taken place at one of the hospitals flooded by Hurricane Katrina, he told CNN Wednesday night.

The subpoenas were served on employees of all levels at Memorial Medical Center, which is owned by Tenet Healthcare, because “cooperation, lately, has not been as good as I had hoped,” Foti said.

The subpoenas require that people appear before investigators for questioning.

“Some people were not coming forward. We learned Tenet sent out a letter that had a chilling effect,” Foti said. “We had no choice but to issue these subpoenas.”

“They [Tenet] seem to be in a position of protecting themselves, while we are just trying to get to the facts of what happened at the hospital,” the attorney general said.

CNN obtained the memo — dated October 14 — to which Foti was referring.

In it, Tenet’s assistant general counsel, Audrey Andrews, advised staff members that “in the aftermath of Hurricane Katrina, you may be contacted by a government representative or a representative of the media.”

“In fairness to you, if you are contacted by a representative of a state or federal agency, or if you are contacted by the media, you may wish to first confer with legal counsel. You have certain legal rights about which you should be aware.

“First, you have the right to decide whether or not you wish to be interviewed. You can consent or decline. The decision as to whether or not you consent to be interviewed is yours alone,” Andrews said.

However, she added that if anyone spoke to investigators, they were obliged to “provide truthful information in response to questioning.”

Three days after Katrina flooded most of New Orleans, staff members at Memorial had repeated discussions about euthanizing patients they thought might not survive the ordeal, according to a doctor and nurse manager who were in the hospital at the time. Katrina came ashore August 29. (Full story)

After allegations of mercy killings surfaced, Foti’s office asked that autopsies be performed on all 45 bodies taken from the hospital after the storm.

Tenet has told CNN that most of the 45 patients who died were critically ill, and about 11 patients died the weekend before the hurricane struck and were placed in the morgue.

“We have asked for certain records from Tenet 15 days ago, and we have yet to receive them,” Foti said. “We have also asked for the location and address of every employee working at the hospital at the time of the hurricane, and they have not provided that either.”

A spokesman for Memorial denied that the hospital has been uncooperative.

“We have never discouraged any employee from working with the Louisiana attorney general’s office. In fact, we know that some have already spoken to his representatives. We’ve been cooperating with the attorney general’s office, and have spoken regularly about employee interviews,” the spokesman said.

Culture Change is happening all over the place. In Illinois, it looks really good. Some homes here are highlighted as to what exactly it is they are doing to make change…

CHICAGO—Today, Illinois nursing homes are taking significant steps to put the “home” back in nursing home. By joining in a revolutionary shift in thinking about life in long-term care facilities—called the Pioneer Movement—nursing home leaders and staff are cultivating elder-centered communities that are more life-affirming, satisfying and meaningful for residents.
Through this growing national movement, thousands of health care professionals from around the country are breaking free from the institutional, hospital-like model that has served as the blueprint for today’s nursing homes. These professionals are:

Making the nursing home environment more home-like;

Having the same staff permanently assigned to the same residents;

Offering buffet meals and restaurant-style service;

Developing spa-like settings for bathing;

Creating smaller neighborhoods within a larger facility;

Bringing in pets, plants and children; and

Offering further opportunities for community involvement, daily activities and increased quality of life.

“Our hope is that the Pioneer Movement will transform the culture of aging in America,” says Myrtle Klauer, an expert on Pioneer Practices and director of resident services at the Illinois Council on Long Term Care. The Council is a statewide association of nursing home professionals whose members are leading the way for the Pioneer Movement in the Midwest. For example:

Residents living at Capitol Care Center in Springfield now have permanently assigned staff that gets to know them and better understand their health conditions, needs and interests. Residents also wake up, bathe and go to bed when they want, instead of following a regimented schedule. The facility is also creating separate neighborhoods within the facility, each decorated with home-like touches chosen by the residents.

Countryside Care Centre in Aurora recently launched a fine dining program to replace its standard tray-based food service. Residents choose from expanded menus that include soups and desserts; enjoy off-tray choices, linen napkins and tablecloths; plan formal dinners that include wine; and are greeted by a hostess during lunch and dinner.

Residents living at Sheridan Health Care Center in Zion enjoy buffet dining. Individuals choose from a variety of hot and cold foods; serve themselves or receive restaurant-style wait service; and sit at tables covered by linen tablecloths and napkins and decorated with flowers. During breakfast, residents enjoy offerings from an omelet station. In addition, this facility is part of the Lake County Pioneer Coalition, in which area professionals share success stories on creating home-like environments for their residents.

Dozens of Illinois nursing home professionals are members of the Illinois Pioneer Coalition, a group dedicated to changing the culture of nursing homes in Illinois. This group sponsored the Illinois Pioneer Summit on Oct. 12 and 13, when experts from around the state met to discuss this historic change with hundreds of Illinois nursing home representatives.

“We want to advance from the standard model for nursing home care to one that is more focused on the residents’ quality of life,” said Klauer. “Residents should have more independence, being able to get up when they want to, choose what they want to eat and go to bed when they’re ready. We want the staff to know more about the residents they serve and develop closer relationships with them. The overriding goal is to make Illinois nursing homes more like a real home.”

Another nursing home gets cited, a resident died after she fell down stairs, in her w/c.

LORAIN — A local nursing home was cited by the Ohio Department of Health after an 90-year-old woman fell down several stairs in her wheelchair and died, according to an Ohio Department of Health spokeswoman.
Autumn Aegis Nursing Retirement Community, 1130 Tower Blvd., was cited for failure to ensure that each resident received adequate supervision and assistance devices to prevent accidents, according to the agency’s investigation report.

Delores Gayoso, 90, got through a secured door in her wheelchair at Autumn Aegis on Oct. 8 around 9 p.m. and tumbled down several stairs. Lorain County Corner Dr. Paul Matus has said Gayoso landed in a position where she asphyxiated herself. Her death was a direct result of the fall, he said.

”It was determined that the facility failed to provide adequate supervision to prevent an elopement and failed to ensure that assertive devices (door alarms) used to prevent elopement functioned properly,” the report said.

The citation is a level ”J” because there was an immediate jeopardy, according to Michelle LoParo, spokeswoman for the Ohio Department of Health. Citations are classified A through L, with A being the least serious and L being the most.

The Ohio Department of Health conducted an investigation after the nursing home filed a facilities self-report documenting the incident. The department finished its investigation Oct. 17 and Autumn Aegis received the citation Oct. 20. The home has 10 days to respond to the complaint.

The report specified that Gayoso was severely confused and had a history of exit-seeking behavior. The resident was placed in ”immediate jeopardy when she exited an exterior door that did not alarm, fell down five concrete steps in her wheelchair and landed upside down on a concrete pad,” the report said.

Within the next 10 days, Autumn Aegis will submit a plan of action or dispute any and all of the allegations with reasons, LoParo said.

Michele Schlabach, spokeswoman for Sprenger Retirement Centers, which owns Autumn Aegis, has said the door Gayoso exited is locked with a code that is only available to staff and family members.

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