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by Torie McCloy
(September 13) Leann Richards may be only 20 years old, but she has a lot of experience when it comes to caring for the elderly. She started volunteering at SunRise Care and Rehabilitation in Salem, then known as Salem Americare, when she was in sixth grade.
Now a Certified Nursing Aide, Richards has grown close to several of the residents. That's why turning in her resignation on Sept. 1 along with six other CNAs at SunRise was one of the hardest decisions she ever made.
The workers, some of whom had worked as many as eight years at the facility, said they could no longer leave work feeling good about themselves. They allege that the residents at SunRise in Salem aren't receiving quality care.
"We're not doing this for us. We are doing this for the residents," said Nancy Cumberledge. "It's a stand for the people who can't stand up for themselves," added Jessica Smarr.
Aides claim some residents go without proper care because they don't have time to help everyone. Each aide was assigned to 15 or 16 residents. That, they said, is too much. Many of the residents at the facility are incontinent and while an aide may be feeding one resident, another may be calling for help to use the restroom, aides said. In addition to feeding and helping residents use the restrooms, they also must wash and care for the residents.
Company officials, however, say the facility meets state guidelines.
"We always meet state codes and often exceed them, including staffing," said Sun Healthcare spokeswoman Phyllis Goodman of the company headquarters in Albuquerque, N.M.
The West Virginia Department of Health and Human Resources confirmed this week that a complaint against the Salem facility has been filed. An investigation is underway, said spokeswoman Ann Garcelon.
As for state staffing standards, Garcelon said it is not as simple as a one-to-five ratio. Staffing depends on the condition of the resident and on the time of day, she said. More staff is required in the day than at night. Specific numbers for the Salem facility's staffing situation won't be available until the investigation is complete, she said.
Sister Anne Francis from Jacob's Well House of Prayer in Salem said if SunRise is complying with state staffing laws, then the laws aren't doing what they should.
According to the booklet "A Matter of Rights," which is published by the national organization CAREsource Program Development Inc. in compliance with a federal law governing nursing home facilities that passed in 1987, the No. 1 policy of a nursing home is "to provide the kind of care to our residents that will maintain and enhance their dignity, individuality and quality of life."
Sister Francis, who regularly visited residents at SunRise, said what she saw and heard didn't meet those standards.
"They don't have enough help," Sister Francis said. "Each resident has a right to the quality of care that will enhance his/her dignity, individuality and quality of life. This is not possible when you have one aide to 15 residents and one housekeeper to 17 rooms. To me this is neglect and abuse."
Goodman said Sun Healthcare, which manages 400 skilled nursing home facilities nationwide, focuses on providing quality care for residents.
"We are always focused on providing quality patient care. That's our focus. That's our goal. That's our job," Goodman said.
Cumberledge disagreed. She said just because the company is in compliance with numbers, it doesn't mean that residents were getting quality care.
Some of the aides said they feared that by working at the facility their licenses could be pulled for neglect as they tried to care for 15 residents. Sometimes, Smarr said, dry pads or gowns weren't available and aides had to use sheets to wrap around residents or put under them for protection.
"A lot of times we had no choices," Smarr said.
The aides said they felt the only way to draw attention to what they allege to be non-quality care was to resign and take a public stand. They said they don't plan on benefiting from their public outcry. But, Smarr added, they hope the residents will.
"If we stand back and say nothing, nothing will ever be done," said John Price, the only male aide who resigned.
"You don't have seven people resigning in spite," Sister Francis added. "They don't have another job to go to. I admire these individuals who have taken a stand to be the voices for the residents of SunRise."
Aides said they tried to go through the proper channels before turning in their resignations. About a month before resigning, they held a meeting with company officials in which they offered to give back a recent 50-cent across-the-board raise that had been given to them Aug. 25 if more aides could be hired with the money.
That didn't happen.
The aides turned in two-week notices on Sept. 1 and were asked to leave on Sept. 3, Sister Francis said. They said it was a hard decision to make. Several, like Richards, don't have another job. Now, although unemployed, they believe they are doing the right thing.
They said their goal is to get things changed at the 128-bed facility, not to get it shut down. Aides said they don't want the residents living at SunRise to lose their home. CNAs Trina Bland and Denise Wyckoff both said the residents become like family members. They want to make sure the residents get the best care.
Instead of shutting down, aides want to see a change -- even if it has to be on the state level.
"I'm pleading with the public and with lawmakers to come up with a law that will regulate the minimum amount of staff -- nursing, housekeeping, dietary and aides -- per nursing facility in this state," Sister Francis said.
Local residents also don't want to see the facility closed.
Salem resident Jennings Goldsmith's father was a resident at the facility from May 1993 to July 1998. Goldsmith, who visited his 89-year-old father quite often, said he received good care at the facility.
"If something wasn't quite right, I would go to the nurse," Goldsmith said. "My father couldn't talk, so I had to observe and find out for myself."
The aides said not all residents are as lucky as Goldsmith's father. Many get few and sometimes no visitors. They don't have someone pulling for them.
Goldsmith said that during his observations, he did notice the aides were somewhat overwhelmed.
"I thought they were real busy," he said. "I didn't see any loafing."
Some of the aides who resigned had helped care for Goldsmith's father, making sure he was able to get out of bed and into a wheelchair each day.
Although Goldsmith is concerned about some of the practices at the facility, he also worries about what the community would do without it.
"We need this place up here bad. I would hate to see anything happen to it."