Editor's Note: This is one in an ongoing series of articles investigating patient care and allegations of abuse at Baycrest Memory Care in Coos Bay. Check back with The World for future articles about the investigation.
COOS BAY — The abuse first discovered at Baycrest Memory Care in 2015, inspired new state legislation, but even that couldn’t change what was happening at the facility.
Baycrest Memory Care announced its closure last month, citing March 1 as the day the doors will shut.
Since then, state representative Caddy McKeown issued a press release noting her disappointment and outrage.
“Despite multiple attempts from the state to bring Baycrest Memory Care into compliance, the current management company has failed to successfully respond to these efforts and, as a result, will now close,” McKeown wrote.
“I am heartbroken and frustrated at the poor conditions these seniors have experienced,” she continued. “In a small town like Coos Bay many of these residents face extremely limited options for relocation, in addition to the stress caused by any change in daily routine for dementia and Alzheimer’s patients. However, we absolutely cannot tolerate exposing our senior citizens, particularly those with dementia, to substandard care.”
How did this happen?
The Department of Human Services found out that something wasn’t right at Baycrest during a survey in 2015, which is an inspection conducted every other year. The department’s licensing team walks through the building to check on clients and go over a variety of rules and regulations.
“There were quite a few citations given back in 2015,” said Ashley Carson Cottingham, director of the Aging and People with Disabilities program for DHS.
“Out of that we ended up putting conditions on their license which is one of the steps we can take in our progressive approach to compliance,” she told The World during a phone interview. “What that means is that we would identify the issue occurring and the condition on their license would be specific to that issue. It would restrict admission during that time so they can correct the problem without new residents moving in.”
Other conditions could include needing an RN at the facility for more hours or additional training for staff. Generally when a building meets these terms, DHS lifts the condition on their license.
Which is what happened.
“There were some struggles so we worked with them to have a new management company come in and take over full operations of the building,” Cottingham said, adding that was part of the settlement agreement DHS reached with them as a way to resolve some of the issues.
The new management company that stepped in was Seasons Management and is still currently in charge.
At first, things improved.
DHS returned for another survey, or inspection, to see how things were going. As of August 2016, Baycrest was found to be in substantial compliance, meaning that all issues had been resolved.
Just a few months later, starting in April of 2017, DHS began receiving allegations of abuse again.
“We had to place a condition on their license again,” Cottingham said. “Then they improved slightly so we amended that condition in September of 2017.”
However, abuse allegations and substantiations kept rolling in through the door at DHS. Something had to be done to fix it.
“So we had to amend the condition again in October to place a restriction of admissions on their license and require a minimum of staffing again and specific recording requirements,” Cottingham said. “Because of the yo-yo compliance, we determined the need to take the next step in our productive process and issue the notice of intent to revoke.”
Notice of Revocation
According to Cottingham, it is rare for DHS to issue a notice of revocation to a facility in the first place. It is even rarer for the facility to respond by giving up and shutting down like Baycrest is doing.
“If the revocation process went to the end of the process, yes their license would be revoked,” she explained. “It’s important to point that generally a facility would contest the notice or have many conversations with the department so we could achieve an agreement to get back into substantial compliance and we would rescind that notice. If they were back in compliance then we wouldn’t go forward with the full revocation of the license.
“It is very rare that this occurs this way.”
Right now there are close to 34 residents at Baycrest Memory Care that now have to be moved to other facilities before the March 1 closing date.
“This is not something the department wants to have occur in a community because memory care services are so critical,” Cottingham said. “The impact on the residents . . . there’s a thing called ‘transfer trauma.’ So that can be very stressful and we want to minimize that stress as much as possible.”
Since the facility has announced its decision to shut down, DHS is working with the management company and owner because “our number one priority is the safe and effective transition of residents,” Cottingham said.
DHS is also making sure to keep families well informed and help them locate new placement facilities for the residents. They are going through a checklist process to also ensure that medications, medical equipment and personal belongings all go with them.
“We’ve hired our own consultant to be in the building throughout the closure process,” she said. “The department funded the consultant in order to have another extra help to the building and ensure the safety and welfare of the residents because it’s such a difficult thing to have happen.”
There’s been 21 instances of confirmed, or substantiated, abuse cases in 2017 so far. DHS is still working to close additional investigations from last year.
“More are still being processed so that number may or may not go up,” Cottingham said. “These investigations range from neglect, some with resident on resident conflict. Some were pretty serious calls.”
“After shutting down, I don’t know if we have the authority to do anything further from the department’s standpoint,” Cottingham said. “There are a number of outstanding civil penalties we’ve assessed for some of the abuse cases, so those have not yet been paid and the department would expect that those fines are paid.”
For 2016 and part of 2017, Baycrest Memory Care still owes $44,400 in unpaid civil penalties.
In McKeown’s press release, she stated that she is grateful to the constituents who alerted her to the problem at Baycrest.
“Since then, I’ve been working with our community and other stakeholders throughout the state to improve the quality of care in Oregon’s residential facilities,” she said. “That work resulted in the passage of House Bill 3359 which improves training, staffing, oversight, and communications within long-term care facilities in an effort to avoid situations exactly like this. Implementation of this bill is just beginning but this situation reaffirms my commitment to seeing this through.
“Our seniors are some of our most vulnerable citizens and they deserve the best care we can possibly provide them. We must do better than this.”
The World filed a Freedom of Information request with DHS to obtain the case investigation files since 2014. Some have already been turned over, though more are still coming in.