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Continued: Last of 3 parts: No easy solutions

In about 60 cases where records showed what happened to the nurses aide, homes fired aides about half the time. In 18 cases, homes issued suspensions or warnings or retrained the aides. In 11 instances, nurses aides quit.

Stress from low staffing

One former nurses aide at Crest View Lutheran Home in Columbia Heights said she got frustrated by staffing levels when she worked there in 2007. She and other former Crest View workers described a lack of teamwork.

"Some people just don't care," she said of co-workers. "Some were in la-la land."

At 4:30 on a Sunday afternoon this summer, the Crest View dining room came alive as staff members in colorful scrubs helped residents to dinner using wheelchairs, walkers and belts.

One hallway was nearly deserted, except for one resident who talked on the phone in her room, another resident who sat near a room window, and a third who quietly ambled down the corridor.

Throughout the hallway, a beep echoed repeatedly. There were no staff members in sight. The nurse's station sat empty.

Crest View, which had at least 13 fall-related deaths from 2002 through 2008, was cited for insufficient staffing early this year as part of regular nursing home surveys.

Regulators have put it on a list of four "special focus facilities" in the state with "a history of serious quality issues" -- a designation Crest View disputes.

As a result, Crest View is inspected more frequently. Other Minnesota nursing homes on the list are Owatonna Commons Nursing & Rehab, McIntosh Manor in McIntosh and Westwood Health Care Center in St. Louis Park.

Crest View Chief Executive Officer Shirley Barnes said the nursing home is staffed at a higher level than required. "We train, we audit, we continually look to improve," she said, adding that internal audits will show "great improvement."

Nursing homes are constantly working to prevent falls, but haven't come far enough, said Fritz, who has proposed and passed bills for nursing home worker and resident safety.

"You've got to have somebody there to answer the buzzer and somebody there to check on the restraint," Fritz said. "You can have all the wonderful equipment in the world, but if you don't have the staff, it's futile."

plouwagie@startribune.com • 612-673-7102 ghowatt@startribune.com • 612-673-7192

  • about this series

  • More than 100 Minnesotans die each year after suffering falls in nursing homes. Few deaths are fully investigated by the state, and serious penalties for violations are rare.
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