NEW INFO: State Cites GlenCare With 5 Violations

A Mount Olive assisted living facility where five residents have died of Hepatitis B has been cited by the state for violations.

To date a total of eight residents of GlenCare have been diagnosed with the highly contagious disease, five of those have died since August. In a report last week, the Division of Public Health said the likely blame for the outbreak was "as a result of unsafe blood glucose monitoring practices."

The Division of Health Service Regulation cited GlenCare for one Type A Violation, and four Type B Violations. The company could be fined between $1,000 and $20,000 for the Type A Violation. The state has yet to determine the exact amount of the fine.

The state says the facility failed to train three medication aides for blood glucose monitoring. It also says during confidential interviews that staff revealed there was only one lancing device at the facility until October 11th. Another staff member told the state that they complained to a supervisor who replied "they did not have individual supplies and it had always been this way."

The report says a staffer told regulators that they only disinfected the glucometers and lancing pens when it looked like there was something on them.

The 19 page report also cited several examples what is says are residents not receiving appropriate care. The report says the facility failed to assure that residents received appropriate care when it came to infection control measures.

It also says one staff member was "nasty" to two women residents and even cursed one of them out in their room so loud that visitors heard, staff and other residents heard it down the hall.

In another case the report says a resident was forced to ride her motorized wheelchair to a downtown church for an AA meeting because she could not get into the facility's vehicle. That van drove alongside the wheelchair to the church. Once at the meeting, it was discovered the church didn't have handicap access and she had to wait outside. The report says the woman then rode her wheelchair back to GlenCare, with their van alongside.

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The Division of Health Service Regulation has ordered the operators of Glen Care assisted living facility in Mount Olive to take immediate steps to ensure the health and safety of their residents while the state continues their investigation into a Hepatitis B outbreak at the facility.

Six steps outlined in the plan of correction include the facility immediately developing and implementing procedures for infection control measures.

Fines for a Type A violation range from $1,000 to $20,000 for homes licensed for seven or more beds.

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A state report says the likely cause of a deadly Hepatitis B outbreak at a Wayne County assisted living center was from blood testing.

Five residents of GlenCare of Mount Olive have died since August and another three have tested positive for the disease.

In a report issued Friday, the Division of Public Health says the outbreak was likely caused "as a result of unsafe blood glucose monitoring practices." The report says it is not possible for the state to determine how the illness entered the facility in the first place.

Hepatitis B is a blood-borne disease that is typically transmitted by exposure to blood or body fluids.

The report says investigators observed glucometers stored together in a single compartment drawer in a medication cart at GlenCare and there were no obvious labels with resident names. They also observed multiple-use adjustable lancing devices kept in a drawer in boxes labeled with resident names.

In its report the state recommends that GlenCare assign separate glucometers to individual residents, consider storing glucometers in a secure area in the resident's room to avoid accidental use by other residents, glucometers should be cleaned and disinfected after each use, and strongly consider using single-use lancets that permanently retract upon puncture.

The Division of Health Service Regulation has been doing its own investigation into the outbreak. That agency will decide whether GlenCare faces any disciplinary action for the deaths and that report should be available next week.

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State officials reported Thursday that five people have now died after a hepatitis outbreak at an assisted living center in Wayne County.

State health officials originally reported four had died, but a fifth passed away in the last week. Officials say three other people got sick.

A preliminary report from the state is expected Friday, which could detail how the disease was transmitted.

GlenCare of Mount Olive made the first public comment about the deaths Thursday morning. Only two television stations were allowed to stay on the property for a news conference. WITN, three others from Raleigh and a radio station were told by police to leave.

WITN and other media outlets were able to obtain handouts from the press conference given by GlenCare.

The handout for GlenCare reports the center received a visit from the local and state health department on October 13, informing the center the hospital had alerted them about three residents who were diagnosed with Hepatitis B.

The handout reports on October 14, another patient was sent to the hospital. On October 15, according to the handout, local and state health officials came to the center and informed the center it had an outbreak of hepatitis.

The handout states surveyors from DHSR, which is the North Carolina Division of Health Service Regulation, contacted the center 16 days after its investigation was complete and said the center was in "immediate jeopardy" because five medication techs told officials they used the same pen on several residents.

The "pen" referred to in the handout is used for finger sticks for medical testing.

The handout also states the center "should have been told immediately that 5 of 5 Med Techs stated they had used the same pen on several residents -- not 16 days later."

The handout from GlenCare also states: "We asked for the names of the Medication Techs who admitted to using the same pen on several residents and DHSR refused to give us these names stating that the interviews were confidential."

The handout goes on to state the center then contacted all the Med Techs and asked them about the DHRS investigation and interviews.

The handout reports "All of the Med Techs stated over and over that they did not ask for a confidential interview and they did not say that they used a pen on several residents. The Med Techs that admit to being interviewed are mostly long term Med Techs with experience ranging from 1 year up to 12 years and have been surveyed by DHSR for years during annual inspections and at least 6 years as GlenCare employees using the same blood glucose monitoring. In fact, all the of the Med Techs stated they had never seen any other Med Tech use the same pen on various residents."

The handout said in lieu of terminating all the Med Techs as the investigation continues, registered nurses are monitoring their actions.

The handout focuses at various points on timing of notifications and investigations.

"We were not notified of the cause of death of our residents until 10/13/10 when the health department first visited the facility. The first resident expired on August 30, 2010. Often the facility does not receive a complete list of resident diagnosis upon admission or readmission from transferring medical facilities. The health department investigators are aware that these residents have gone to other medical facilities on numerous occasions, 2 residents were to the dentist, several were seen by the podiatrist and most of them received home health nursing procedures. We have not received anything in writing from the health department as of this date regarding their findings however they have identified diabetes as a common thread."

To view the handout from GlenCare, click on document link at the top of the story.

According to officials, there are a total of eight confirmed cases of Hepatitis B at the facility.

Tests were offered to everyone at the facility, along with former residents since January. The Division of Public Health says it hopes to have its investigation into how the cases were transmitted by early next week.

Hepatitis B is a blood-borne disease that is typically transmitted by exposure to blood or body fluids. So far public health officials have not pinpointed the cause of the infections.

Previous Story, from October:

State health officials are investigating an outbreak of Hepatitis B in which four patients have died at a Wayne County assisted living center.

At the current time, a total of six residents at Glen Care of Mount Olive have come down with the disease since late-August. The center is now providing testing for all residents and letters have gone out to all residents and families.

State public health officials are recommending that all residents of the facility be vaccinated to prevent any future Hepatitis B outbreaks.

“We are working with facility staff to ensure that any residents or staff who may have been exposed receive proper care and to prevent any further spread of the virus,” said Dr. Jeff Engel, State Health Director.

The facility was last inspected by the Division of Health Service Regulation on April 12th and no violations were found. Glen Care was given a 3 star rating, out of four. Facilities must have two consecutive 100% or greater ratings to obtain four stars.

Hepatitis B is a blood-borne disease that is typically transmitted by exposure to blood or body fluids. So far public health officials have not pinpointed the cause of the infections.

“Based on our experience in similar settings, we believe the illnesses may be associated with healthcare delivery but are also investigating other possibilities,” Engel said. “This should be a reminder for other long term care facilities to review their infection control practices and make sure they're doing everything they can to protect residents from infection.”

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