At 93, Parasites Ate Her Alive At A Nursing Home

INSUBCONTINENT EXCLUSIVE:
Authors: TheIndianSubcontinent News Agency
Pictures of Rebecca Zeni during her younger years showed her with flawless skin, well-defined eyebrows and long, thick
lashes
Her hair, parted in the middle, was neatly tied with a bow behind her ear.Her beauty could capture a room, her daughter said, but she was
more than just a beautiful face.She was a modern-day woman of the 1940s and 1950s, headstrong, career-oriented and hard-working, said Mike
Prieto, a lawyer representing Zeni's family
At a time when women were expected to marry young and have children, the small-town girl from North Carolina moved to Norfolk after high
school to work at the naval base there, her daughter, Pamela Puryear, said
She later became a model in New York City and worked as an assistant for CBS News's Mike Wallace before she married and became a
stay-at-home mother."Her life just became exciting," Puryear said
"She thought in her mind that everybody's life is just like this."But the once-vibrant woman later found herself living in a nursing home,
where she suffered a long, painful death, her family's attorneys said
Parasitic mites had burrowed under her skin, living and laying eggs all over her body
By the time she died, vesicles and thick crusts had formed on her skin
Her right hand had turned nearly black, and Prieto said her fingers were about to fall off.The scabies that infected Zeni's body had become
so severe that bacteria seeped into her bloodstream
She died in 2015 at age 93.Zeni's death is now the subject of a lawsuit filed against PruittHealth, a for-profit company that owns dozens of
nursing homes, including Shepherd Hills in LaFayette, Georgia, where Zeni lived for five years until she died
Shepherd Hills, a nursing home that had multiple scabies outbreaks in recent years and a history of health violations, failed to follow
policies and procedures to prevent the occurrence and spread of the highly contagious disease, documents say
Instead of providing the care that Zeni desperately needed, the lawsuit alleges that the nursing home allowed her to die an agonizing
death."The last six months of her life, she was in constant pain," Prieto said
"She was literally being eaten alive from inside out."Zeni's death raises crucial - and familiar - questions about for-profit nursing homes
that have long been accused of sacrificing patient care to minimize costs and maximize bottom lines
Nursing homes owned by big corporations and private investment firms consistently performed poorly in terms of quality of care and are more
likely than nonprofit and government facilities to be cited for "serious deficiencies" that harm residents, according to 2011 and 2016
reports by the Government Accountability Office
Staffing levels are usually lower, meaning trained nurses spend less time with residents each day."You must consider that the reimbursement
rate from [Medicare] continues to fail to keep up with rising costs that's associated with care," said Prieto, who focuses on nursing-home
litigation
"The only variable that's available for these for-profit facilities to ensure they continue to maximize their opportunity for profiting is
staffing
Purposefully understaff facilities in an attempt to ensure maximum profit."Avi Mukherjee, a professor at Marshall University who focuses on
health-care management, said high staff turnovers, diminishing morale, and meager pay and benefits often result in low quality of care."The
key is to understand that low service quality and negative outcomes for patients and residents is not in the interest of the long-term
survival of these companies," Mukherjee said.PruittHealth's spokesman and attorneys did not respond to calls or emails seeking
comment.Federal health inspection records paint a troubling picture of the company, which describes itself as the "regional leader" of
providing long-term health care to the elderly in the southeast.Shepherd Hills was ordered to pay $337,786 in penalties over the past two
years and has a one-star rating - the lowest - from Medicare based on health inspection results, staffing and quality of care.In 2016, for
example, the facility was penalized for several staff medication errors, some of which resulted in life-threatening situations
One resident was mistakenly given morphine twice within a half-hour one morning and continued to receive the medication every two hours
later that night and the following day, records show
The resident overdosed and was rushed to the intensive care unit.State health inspection records obtained by 11Alive, which first reported
on Zeni's case, showed nearly three dozen violations in 2014, 2015 and 2016
The NBC affiliate reported that state officials threatened to withhold federal funding if the violations weren't addressed.Many
PruittHealth-owned facilities have similarly dismal records
Nineteen other facilities in Georgia, seven in South Carolina and one in North Carolina received one- and two-star ratings from
Medicare.According to the Government Accountability Office's 2016 report to Congress, skilled nursing facilities received $28.6 billion in
Medicare funds in 2014
About 70 percent of these facilities are for-profit nursing homes.Zeni was admitted to Shepherd Hills in 2010
By then, the 87-year-old had been diagnosed with dementia, diabetes and other illnesses
She was completely dependent on others and was no longer legally qualified to stay at an assisted-living facility.Puryear, who lives in
LaFayette, was close enough to visit often.Zeni's rashes began to appear in fall 2013, around the time that a scabies outbreak at the
facility was reported to the local health department
Ten residents and 10 staffers had rashes; some were diagnosed with scabies, according to Georgia Department of Public Health
records.Attorneys for Puryear said the nursing home did not take the necessary steps to keep the outbreak contained and to properly treat
residents
Sheets used by those infected were washed along with those of the general population, and medication was shared among residents
Families were not informed of the highly contagious disease, said attorney Stephen Chance; instead, vague signage about a rash was posted at
the facility
Residents with scabies were not quarantined, and infected staffers returned to work."Once you got a number of people that are carrying
scabies, and they go home and they have it at home and they're coming back to work, going from one patient room to another patient room,
that sort of approach is not going to eradicate scabies," said attorney Lance Lourie.Lourie added: "Nursing homes in this chain in
particular, they're under a tremendous pressure to keep the facility full
Telling all your residents that you got an outbreak of scabies in the facility would hurt your ability to get more residents and families
will leave."Another outbreak occurred in 2014, Chance said, but that was not reported to the health department
A third outbreak happened in spring 2015
Twenty residents and 15 staffers were infected, state records show.By then, Zeni's condition had dramatically worsened
Rashes had spread to her scalp, neck, chest, shoulders, back and arms
A doctor had ordered that she be given Ivermectin, a tablet used to treat worm infections, and Elimite cream, which is used to treat scabies
But the treatments and medications were at times not given as ordered, court records say.Zeni died June 2, 2015
An autopsy found that she died of Staphylococcus aureus septicemia due to Norwegian crusted scabies, a severe form of scabies that affects
people with weak immune systems, such as the elderly
Scabies can spread rapidly in crowded places, such as nursing homes, extended-care facilities and prisons, according to the state health
department.An affidavit by Debi Luther, a Florida nurse who reviewed Zeni's medical records, stated that the nursing home's failure to
recognize her deteriorating condition and to prevent the spread of scabies resulted in her death.Nancy Nydam, spokeswoman for the Georgia
health department, said the agency provides guidelines to prevent and control scabies outbreaks and follows up with facilities, but it does
not have regulatory control.A separate agency, the Georgia Department of Community Health, inspects facilities and could set rules that a
facility must follow
But that agency said it does not have records showing it was notified of the scabies outbreaks, 11Alive reported."At the end of the day, our
client trusted them and her trust was betrayed," Prieto, one of the attorneys, said of Puryear.Puryear said she watched helplessly as she
visited her mother every day, unable to touch or hug the woman she loved and admired."It's a nightmare," she said, adding later: "There was
no dignity."(Except for the headline, this story has not been edited by staff and is published from a syndicated feed.)