Jones' condition seemed suddenly to have worsened. The 67-year-old was in bad shape -- gaunt and anemic, with a painful urinary tract infection, rectal bleeding and a swollen right leg that had ballooned to twice its normal size.
The ambulance arrived, and medical technicians transported Jones across town to Providence Medical Center. There, doctors made a disturbing discovery.
Jones' daughter, Debra Gatson, had checked him into Medicalodge in late summer 2001. An entry on Jones' medical chart from August 28, the day he checked in, shows Jones had two minor bedsores (common when a bedridden patient isn't turned often enough and blood has trouble circulating to the skin). With proper care, they should have healed quickly.
But the hospital physicians who examined Jones six weeks later found sores all over his body, where skin and muscle had been eaten away by lack of circulation. One sore was so deep that bone was exposed. Hospital workers took photos to document the gory, bright-red lesions.
"The nursing care he needed was as simple as turning and repositioning ... every two hours or more often, as needed," says Ruben Krisztal, an Overland Park lawyer who represents Gatson. When the doctors at Providence examined Jones, Krisztal says, their findings contradicted information Medicalodge staffers kept on Jones' medical charts. The charts say only that Jones' two bedsores stayed the same for the six weeks following his admission.
Medicalodges Inc. bills itself as a provider of compassionate care. "We value the human dignity of our residents and base our care programs on that foundation," Medicalodges Inc. advertises on its Web site.
At the hospital, doctors operated to try to repair the wounds Jones had developed at the nursing home. Three days later, because a large, deep sore on his buttocks prevented Jones from going to the bathroom normally, surgeons had to perform a colostomy.
By the end of October, Jones was able to return to Medicalodge. There, however, his health deteriorated again. The day after Christmas, he went back to the hospital, suffering from a high fever, another urinary tract infection, malnutrition and infected bedsores. Jones' lower right leg bone was broken. His swollen leg had developed gangrene, and doctors amputated it above the knee. Jones remained in the hospital and died in March 2002.
In May 2003, working on behalf of Jones' daughter, Krisztal filed a lawsuit against Medicalodges Inc., which operates the home Jones was living in and two other nursing homes in Kansas City, Kansas. Jones' lawsuit accuses Medicalodges Inc. and the Medicalodge Post-Acute Care Center of negligence, alleging that workers at the nursing home failed to provide a care plan for Jones, failed to properly treat his bedsores and failed to follow doctors' orders and their own policy manual. The suit, which alleges that the nursing home was understaffed and that managers had not hired enough "trained and competent" staff members, makes a wrongful-death claim against Medicalodges.
In the past year, four similar lawsuits have been filed against Medicalodges Inc. in the District Court of Wyandotte County, naming all three Medicalodges Inc. facilities in Kansas City, Kansas.
Marilyn Papa-Hansen filed her suit in late July this year, after the death of her mother, Mary Papa, who had checked into the Medicalodge Post-Acute Care Center in March 2002 to recover from a sprained ankle. Papa-Hansen alleges that doctors and workers there repeatedly failed to consider lab results showing that Papa's kidneys were functioning poorly. Papa eventually died of kidney failure.
Another of the lawsuits, filed by Jessie Mae Carr in November 2002, alleges that staff negligence at the Alzheimer's Center of Kansas City contributed to the death of her husband, Tomie Carr. She claims that he received inadequate care for urinary tract infections, dehydration and kidney problems.
No trial dates have been set for the lawsuits, four of which allege wrongful death.
Kansas nursing-home regulators can't say whether the company's facilities are worse than other area nursing homes.
Because of the way Kansas keeps state records, it's difficult to quantify complaints in order to compare nursing homes, says Doug Farmer, a spokesman for the Kansas Department on Aging. Farmer told the Pitch that because the state does not distinguish among complaints, other reports and inquiries about individual facilities, he could not specify the number of complaints filed against the three local Medicalodges Inc. facilities for any given year.
The Department on Aging, which regulates all of Kansas' nursing homes, just took over that responsibility from the Kansas Department of Health and Environment in July. The Department on Aging is now charged with conducting an annual inspection of each licensed nursing home and tabulating "deficiencies" that the home needs to correct. The department also investigates complaints, which then become public record if inspectors find a problem.
Of the three Medicalodges in Kansas City, Kansas, only Medicalodge East on Leavenworth Road has a public record of complaints against it. State records show that in December 2002, KDHE investigators visited the home in response to complaints and found a number of violations, including poor grooming, neglect of residents and failure to provide proper equipment for residents. At least five residents were dirty and claimed that they had not been bathed in a month but were afraid to complain for fear of being punished. One resident was naked from the waist down and lying in a pool of "dried liquid feces." Another was tied to a bed with wrist restraints, lying in "liquid bowel movement" and wearing a catheter that was covered in dried feces all along the tubing to the drainage bag.
Investigators observed a morning breakfast session in which nursing-home workers ignored a mentally impaired resident who was unable to use a spoon. "From 9 to 9:15 a.m., the resident attempted to eat hot Cream of Wheat cereal. Although staff were present, they failed to offer assistance to this resident. The resident finally picked up the bowl with the left hand and attempted to lick the contents out of the bowl." The investigators interviewed residents who reported that workers would wake them up and dress them as early as 4:30 a.m., then force them to sit in the lobby and wait up to four hours for breakfast.
The investigators also found that nursing home workers hadn't properly positioned some residents who used wheelchairs and needed special supports for amputated or inflamed legs. They reported that workers said they "had ordered parts for the wheelchairs but didn't know what had happened to them."
The nursing home Jones stayed in, the Medicalodge Post-Acute Care Center, does not have a similar list of deficiencies on file. But Krisztal, a specialist in nursing-home litigation, says that state investigators see only a tiny fraction of what occurs in any nursing home.
More than 100 patients live in Wyandotte County's three Medicalodges Inc. facilities, where the company charges up to $154 a day for basic care. According to the Medicalodges Web site, the employee-owned company has been in business for 42 years and now owns 25 nursing homes across Kansas -- doing much of its business in tiny, rural towns such as Paola and Eureka. The company also owns some assisted-living facilities and a few nursing homes in Arkansas and Missouri.
Medicalodges President Garen Cox declined to discuss the company or the suits filed against it. "Since it is pending litigation, I don't feel it would really be appropriate to comment at this time," he told the Pitch.