CHCS cited in death of client found in snow > State finds health care workers’ response deficient

BANGOR — Community Health and Counseling Services has been cited for failing to initiate an emergency contingency plan in the case of a 67-year-old client with Alzheimer’s and Parkinson’s diseases who died last month while lying overnight in the snow just outside her Bangor Gardens home.

When a home health worker was unable to make contact with Marguerite Rice the evening of March 16, her supervisor should have notified Rice’s daughter, Cindy Smith of Brewer, according to a Department of Human Services Division of Licensing and Certification statement of deficiency which was issued April 20 after a two-week investigation.

Smith called DHS soon after her mother’s death, complaining that the woman had lain outside for 14 hours because CHCS home health care workers had not carried through with their daily visits or notified her after they had been unable to make contact with her mother.

Rice, who was found at 7 a.m. March 17 by a neighbor, appeared to have died quickly as the result of a heart attack, according to the police report. Wearing a coat, sweat pants, sweat shirt and boots, she was lying next to a supermarket bag full of trash, apparently headed to her garage where her trash barrels are stored, the report stated.

During a random sampling of records that was part of its investigation DHS also discovered that the agency had failed in two out of four cases to notify patients in advance about the type of services for which they were expected to pay.

An investigation of one case may turn up other deficiencies, according to Sandy Bethanis, assistant director of the DHS licensing bureau, who said health services surveyors review records “that are around the complaint issue.”

“We don’t just look at one record, but at a process,” she said.

CHCS must issue a plan of correction by May 3, according to Bethanis, who said that the case will be referred to the State of Maine Board of Nursing for further investigation.

A private, nonprofit mental health and home care agency, CHCS employs nearly 1,000 people and serves approximately 6,500 clients in seven Maine counties.

Smith hired CHCS last August — one month after her mother was diagnosed with Parkinson’s and Alzheimer’s — to visit Rice between 6 and 8 p.m. daily to feed and bathe her, take out her trash, get her ready for bed and perform any other necessary tasks.

CHCS was receiving $1,400 a month to care for her mother, according to Smith, who said private insurance paid for the home care and doctor’s visits, while Medicare covered medicines, prescriptions, walkers and canes.

CHCS public relations manager Diane Nelson said the agency is “in the process of responding to the DHS report.”

Three years ago, the department opted not to renew a Portland-area home health care agency’s license after an investigation turned up evidence of fraud as well as problems with care and services, Bethanis said.

Cindy Smith said Tuesday that she was not altogether happy with the results of the investigation, and that she plans to write to the board of nursing requesting that the morning supervisor and registered nurse who oversaw her mother’s care also be investigated.

Although Smith said she “felt good” that the DHS survey was able to bring to light flawed billing practices by CHCS, she considers her mother’s case far from closed.

“I’m happy they did something, but they could have done more,” she said. “It’s not finished — there’s still more going on here than meets the eye and I’m going to find it.”