Alden Place licensee takes on state
VERGENNES — The operator of the Alden Place Residential Care Home in Vergennes has appealed the state’s late-May revocation of her license. She and her lawyer said that many of the complaints about her management of the home are untrue, and that state officials never allowed her to tell her side of the story during the investigation.
Vergennes resident and Alden Place licensee Virginia “Virgie” Booska and Middlebury attorney Anthony Duprey appealed Booska’s license revocation to the Department of Disability, Aging and Independent Living (DDAIL) immediately after DDAIL made the late-May decision.
According to Duprey and Booska, DDAIL Deputy Commissioner Brendan Hogan heard the appeal on June 15, after the 13 elderly residents of the home had been relocated.
Hogan, who earlier had argued against Booska in a Washington Superior Court hearing, this week declined to say who heard the appeal when asked. Hogan and a DDAIL attorney declined comment except to say that a decision on such appeals is usually made within 15 days, and that in the case of a denial a further appeal could go before the Human Services Board.
The seven-member Human Services Board is appointed by the governor and, according to the Agency of Human Services website, acts “as a fair hearing board for appeals brought by individuals who are aggrieved by decisions or policies of departments and programs within the Agency.” A Human Services Board decision may be appealed to Vermont Supreme Court.
Duprey and Booska in an interview this week painted a different picture than that illustrated in a 32-page May report on Alden Place that was filed by DDAIL’s Division of Licensing and Protection. That report, based on inspections of Alden Place on May 12, 13 and 19, alleged 23 violations of residential care home regulations.
Booska, who was away last week and so could not comment for a story in the June 10 edition of the Independent, said she was stunned by that report.
“I was thinking, ‘Where did they come up with all this stuff?’” Booska said.
The list of violations included inadequate staffing to provide for the medical needs of the home’s 13 elderly residents, including failure to provide needed medication in a timely manner; giving drugs and using medical restraints without doctors’ orders; having untrained personnel give drugs; acceptance of a resident the facility could not handle; and unauthorized use of video and audio surveillance.
Duprey and Booska contested the allegations.
One was that an elderly patient had to crawl up the stairs to an on-site apartment to seek anti-nausea medication. Booska said the patient had been filmed being helped up the stairs by an aide, although state officials had removed the hard drive with that evidence.
An off-duty medical technician was also called and soon administered drugs, said Duprey, who called the report’s account “misleading.”
“They make it sound like there was no one here to help. Someone immediately called another med tech, and within 12 minutes she was there,” Duprey said.
The unresponsive employee in the apartment, a licensed practical nurse who was on call, was “passed out,” Booska said, and was soon fired at Booska’s request — over the objections, she said, of the Alden Place administrator and RN, both of whom gave notice just before DDAIL ordered Alden Place closed. According to the state report, the LPN admitted that in another instance she had been drinking on the job.
Booska and Duprey said Booska clashed with both of those employees over that personnel issue, and Booska also blamed the LPN for another violation cited in the report, failure to accurately count prescription drugs.
Another violation cited was the unauthorized use of a bed rail for one resident. The report alleged there were no doctor’s orders for its use. Duprey and Booska said there were.
“If they’re not in the file, then someone had removed them from the file,” Duprey said. “We don’t know who. Disgruntled employee? Those can be obtained from the doctor’s office.”
Booska addressed the allegation that her staff was not qualified.
“All the med techs are certified … They have to take a test every year to be certified,” she said.
The report said residents were often alone and at risk. Booska disagreed.
“Regulations state for up to 15 people you only need one person … I had a med tech and two aides on morning and afternoon. Nights I had two,” Booska said.
Duprey addressed the video surveillance issue. He said other nursing homes use similar equipment in similar public areas (hallways, drug storage rooms, offices and entryways), that there are no regulations banning cameras, and that Booska has residents’ permission for their use.
Booska addressed alleged unauthorized drug administration.
“If they get drugs, they have an order for it. If they get a Tums, it’s somebody’s mistake, they didn’t call the doctor and say, ‘Can we give him a Tums, he has a tummy ache?’” Booska said.
Booska admitted at least one resident was probably admitted to Alden Place without proper screening, but said she took the word of an RN formerly employed there that she could perform the screening after the fact. Booska said she was frustrated that she was blamed for that violation, and Duprey said state officials typically grants waivers in such cases.
The report also cited uncorrected violations from a November 2009 inspection. Booska at that point had a partner in running Alden Place; the two took it over about a year before. Booska’s former partner was both the administrator and RN, positions the state requires in facilities like Alden Place.
Booska and her partner disagreed about operations, Booska said, and she bought out the partner in January and hired the administrator and RN who left late last month. Since then, the state has continued to mail material relating to the November violations to the attention of Booska’s former partner. Booska said her administrator forwarded them to the former partner instead of Booska — Booska never saw them.
Duprey produced recent mail addressed to Booska’s former partner.
“It is addressed to the prior administrator. And (the most recent administrator) is forwarding those statements related apparently to the deficiencies to the former administrator instead of opening them and seeing what their dealing with,” Duprey said. “They’re not getting their mailings right.”
Duprey and Booska said when DDAIL’s Division of Licensing and Protection officials showed up at Alden Place in late May, the officials never heard any of Booska’s counter points, although the inspectors met extensively with the soon-to-depart administrator and RN.
Duprey and Booska said Booska had recently disagreed with both employees about management issues, including the firing of the LPN, and had both recently given notice: The RN left on May 14 and the administrator on May 28.
Duprey and Booska said the two were the source of complaints about Alden Place that triggered the state investigation. Hogan two weeks ago declined to identify the source of the complaints, citing confidentiality.
Duprey said Booska said the administrator “made it clear to her that she had filed a complaint to the state,” and that “somebody in the agency had indicated there were complaints that came from management.”
In Duprey’s words, Booska was denied due process because state officials never interviewed her during their three visits to Alden Place, while they met regularly with the administrator and RN.
“They refused to talk with Virgie at all,” he said. “They did an investigation that involved her business here with absolutely no communication. They didn’t sit down to go over any of these questions, and had they done that they would have seen a much clearer picture of what was going on here.”
Booska described one May 13 incident. She said state officials called a meeting at her business, but the director of the Division of Licensing and Protection refused to let her attend.
“She said to me, ‘We’re not talking to you,’ and she slammed the door in my face, and I have witnesses to that fact,” Booska said.
Duprey said he asked state officials to stop any closure action until Booska could tell her side of the story, but heard nothing back until the June 15 hearing with Hogan was scheduled; by then, Alden Place’s 13 residents had been moved to new homes.
“We asked him to stay the enforcement action until we could appeal. The state didn’t respond to that at all until it was a couple weeks after that,” Duprey said.
On June 4, a receivership hearing was held in Washington Superior Court, a follow-up on the appointment of Shard Villa administrator Deb Choma as the receiver, or overseer, of Alden Place.
By late the week before, Duprey said he and Booska, working with DDAIL officials, had lined up a new administrator and RN to replace the departing employees. The state filing on June 4 ignored that and other facts, Duprey said.
“They make it sound like there was no plan for an RN and an administrator at this facility, and misleading is the most generous way that I can describe that,” he said.
Hogan also spoke on behalf of DDAIL in court that day, something Duprey said may not bode well for the decision on the June 15 appeal of Booska’s license revocation.
“He was there defending the actions of the agency and telling the judge how appropriate it was,” he said. “It sounds like Deputy Commissioner Hogan has already made his decision.”
Booska and Duprey both insist the judge at that June 4 hearing also said he never intended that the receiver find new homes for the residents.
“No application was ever made, no motion to the court, to close the facility,” said Duprey, adding that the judge said it was his “understanding was you (the state) would come in and continue to operate it.”
Ultimately, Duprey said, the state let down its citizens.
“The people of Vermont deserve better than that,” Duprey said. “The way this all came down, there certainly was no due process at all.”
Booska also produced letters of support from a half-dozen residents and one family member, calling Alden Place “a great place,” calling the care “very good” and “very satisfactory,” saying the residents are “treated well,” and, in the case of the family member, criticizing the state for handling the situation “in the poorest manner possible” and in an “insensitive and disrespectful” manner.
Booska, who has 20 years of experience caring for the elderly, said she would like to return someday to operating her business.
“I really would love to, because I really do care about the elderly,” she said. “When I took over, I said to the girls, ‘This is not going to be an institution. This is going to be a home.’ And that’s what it was.”
Andy Kirkaldy is at [email protected].