Ky. nursing-home company closes 2 Louisville homes, agrees to pay $1 million penalty; inspectors found rodent infestation and filth

Exceptional Living Centers of Lexington, which operates several Kentucky nursing homes. "has agreed to close two of its Louisville facilities, displacing roughly 200 people, after state inspectors uncovered serious problems over the past six months, including a rodent infestation, filthy living conditions and a general lack of care for the elderly and ailing residents," John Cheves reports for the Lexington Herald-Leader.

The company and the federal government entered a settlement last week in U.S. District Court "to voluntarily terminate its Medicare provider agreements at Hillcreek Rehabilitation and Care and St. Matthews Care and Rehabilitation Center. Such a loss is typically a financial death blow for a nursing home," Cheves reports. "The company is working closely with state and federal officials to transfer residents of Hillcreek and St. Matthews to other nursing homes around Jefferson County by July 6, according to its closure plan, obtained by the Herald-Leader. The company also agreed to pay civil monetary penalties of $1,026,408 to the U.S. Centers for Medicare and Medicaid Services."

Inspection reports of the state Cabinet for Health and Family Services, "which inspects nursing homes on behalf of the federal government . . . cited a persistent rodent infestation; unheated bedrooms in freezing winter months; filthy living conditions, including dirty bathrooms, the lingering stench of urine and feces, and trash cans overflowing with adult diapers; a lack of clean linens; blood-testing equipment that was not sanitized between use on different patients; and direct-care employees hired despite having disqualifying criminal records," Cheves reports.

Hillcreek Rehabilitation and Care (H-L photo by Marcus Dorsey)

At Hillcreek, 3116 Breckenridge Lane, "Residents complained that staff did not check on them overnight, between 7 p.m. and 7 a.m., leaving them 'humiliated' and 'feeling dirty' in soiled pajamas and sheets because nobody responded to their calls for assistance, inspectors wrote. A resident who fell in his unheated room the day after Christmas lay uncovered on the floor for more than three hours until he finally was discovered, inspectors wrote. Emergency medical workers described his skin as 'freezing cold.' He died 10 days later at the hospital of hypothermia, they wrote."

The reports say residents and staff told inspectors they were scared by mice and rats scurrying through parts of Hillcreek, "including bedrooms and on a resident’s bed, and by hearing them skitter and shuffle on the floors," and one resident required medical care after a rat bit his thumb, Cheves reports. Inspectors found rodent feces near a nurse's station, and one rat was so familiar that housekeeping staff gave him a nickname, “Ben,” inspectors reported. One nurse “stated the rats were ‘huge’ and as big as cats,” inspectors wrote.

"Hillcreek, which already had a history of critical state inspections, has been hit with about a dozen negligence or wrongful death lawsuits filed by residents’ families since 2021. It is rated with one star, or 'much below average,' on Medicare’s Nursing Home Compare website," Cheves reports.

"At St. Matthews, inspectors cited abuse of residents, including 'a severely cognitively impaired' female resident whom police determined to have been sexually assaulted at the facility, and a resident who said she or he was hit by an employee but whose assault allegation was not reported up the chain of command, as required. As at Hillcreek, inspectors said St. Matthews used blood-testing equipment on different patients without sanitizing it, risking the spread of infectious diseases and blood-borne pathogens, and it hired direct-care employees despite 'disqualifying events' in their past, such as a social services assistant with a conviction for physical harassment."

Exceptional Living Centers President Tom Watts declined to comment to the Herald-Leader, as did the company’s lawyers. The firm continues to operate these facilities listed on its website: Bluegrass Senior Living in Somerset, Clifton Oaks Care Center in Louisville, Green Hill Rehabilitation and Care in Greensburg, Lyndon Woods Rehabilitation and Care in Lyndon, Stanford Care and Rehabilitation, Frankfort Care and Rehabilitation, and Vanceburg Rehabilitation and Care. 

Health officials warn outbreak of drug-resistant bacteria is likely coming from petting puppies in pet stores; 3 of 30 cases are in Ky.

By Melissa Patrick
Kentucky Health News

Getting a puppy for Christmas? Keep clean and take it to a vet. At least 30 people in 13 states have been sickened by a drug-resistant bacteria that federal health officials say was likely picked up from puppies in pet stores, three of them in Kentucky.

Getty Images photo, via WJW-TV, Fox 8 Cleveland

The infection is from a multi-drug-resistant strain of the bacterium Campylobacter jejuni. The outbreak has caused four hospitalizations, the federal Centers for Disease Control and Prevention said in a news release.

The CDC noted that the hospitalized ranged in age from 8 months to 70 years old.

Among 24 people with infections who were interviewed, 21 said they had recently touched a puppy and 15 of those said they did so in a pet store. All of the cases were reported between January and November.

"Campylobacter bacteria can spread to people through contact with poop of infected animals and contaminated food or water," says the release.

Infection from the Campylobacter bacteria is one of the most common causes of diarrheal illness in the United States, infecting more than 1.5 million people every year, says the CDC. Most cases are not part of a recognized outbreak.

The release notes that a single, common supplier of puppies has not been identified. However, 12 of those who had contact with a puppy did so at a Petland store, and five of the 12 were Petland employees. Petland has two locations in Kentucky, in Florence and Ashland.

The CDC adds that the strain of Campylobacter in this outbreak appears to be related to a strain that caused a similar outbreak of puppy-related human illness in 2016.

In a statement, Petland said that just like a 2016 outbreak, this specific Campylobacter strain has not originated at any specific Petland store. The company said it implemented all recommended protocols from federal and state officials to prevent human and dog illness after that outbreak.

Campylobacter jejuni oubreak as of Dec. 11, 2019

"For perspective, more than 12 million guests visit our stores annually, and during this specific time period, Petland estimates more than 2.4 million customer socializations of Petland puppies," says the statement.

Illnesses have been reported in Connecticut, Florida, Georgia, Illinois, Kentucky, Maryland, Minnesota, Nevada, Ohio, South Carolina, Tennessee, Utah and Wyoming.

Symptoms of Campylobacter infection include diarrhea, fever and stomach cramps that begin two to five days after being exposed to the bacteria. The illness usually lasts about a week and most people recover without antibiotics. Antibiotics are needed for patients who are very ill or those with severely weakened immune systems.

The CDC encourages people to make sure they take a new puppy or dog to a veterinarian for a checkup within a few days after getting it because puppies and dogs can carry the Campylobacter germs even while appearing healthy and clean.

The agency also advises people to always wash their hands thoroughly with soap and water after touching a puppy or dog, after handling their food and after cleaning up after them. Also, don't let dogs lick around your mouth and face, open wounds, or areas with broken skin.

The release says the CDC the investigation is ongoing and the agency will provide updates when more information is available.

Ky.'s hepatitis A outbreak is over 3,000 cases. It may be slacking off, but it's done that before. Advice: wash hands, get vaccinated.

Chart by WKYT-TV, based on data from Kentucky Department for Public Health, adapted by Kentucky Health News

Kentucky Health News

Kentucky's hepatitis A outbreak appears to have hit a plateau or even be slacking off, but it has made such moves before, and then resurged. And the state continues to record about 60 new cases a week. The state Department for Public Health has logged 3,122 cases from September 2017, the start of the outbreak, through the first week of December 2018.

That being said, the department's most recent weekly report showed the largest one-week drop in reported cases since the outbreak began, to levels that haven't been that low in five months. The biggest single week was in late October.

The outbreak has been blamed for the deaths of 19 Kentuckians, "and 82 percent of Kentucky's 120 counties have reported at least one case," Lexington's WKYT-TV reports. "More than half of the cases have led to patients being hospitalized. . . . Carter County has the highest incident rate per capita."

Hepatitis A is transmitted by oral contact with fecal matter, and there is no cure, so authorities urge hand washing and vaccinations. The disease attacks the liver and causes symptoms including abdominal pain, nausea, diarrhea, fever and yellowing of the skin.

Hepatitis found among three more Lexington-area food workers

Lexington Herald-Leader graphic

Three more restaurant workers in the Lexington area have been found to have hepatitis A, but the state still has no food-borne cases of the disease more than 15 months into a statewide outbreak of then liver disease, health officials said.

"Anyone who ate in November at the Hardee’s at 2990 Richmond Road in Lexington, the Waffle House at 2347 Buena Vista Road in Lexington or the Waffle House at 4 Carol Road in Winchester may have been affected," Morgan Eads of the Lexington Herald-Leader reports, based on information from the Lexington-Fayette County Health Department.

The department said in a news release, “While it is relatively uncommon for restaurant customers to become infected with the hepatitis A virus due to an infected food handler, anyone who consumed food or drink at these locations during the stated time period is advised to get a hepatitis A vaccination.” It said the three employees won't return to work until they are medically cleared.

Hepatitis A can be transmitted from person to person by food or water contaminated by fecal material. Symptoms include fatigue, stomach pain, nausea, darkened urine and yellowed skin. The health department recommends getting vaccinated for the disease and carefully washing hands with warm water and soap after using the bathroom, and before making food and drinks.

Through Nov. 17, the outbreak had affected 2,769 Kentuckians, hospitalized 1,438 and killed 17, according to the state Cabinet for Health and Family Services.

As hepatitis A outbreak continues in Kentucky, health officials say vaccine is best way to protect yourself; and wash those hands!

By Melissa Patrick
Kentucky Health News

Since state officials declared an outbreak of hepatitis A in November, Kentucky has had 577 confirmed cases of it. That's almost 30 times the state's average of about 20 cases a year, and five of those 577 people have died from the liver disease.

The most common prescription for preventing hepatitis is hand washing, but the absolute best way to avoid the highly contagious disease is vaccination, which requires two shots, six months apart.

The first dose provides more than 90 percent immunity, but getting both shots offers lifelong protection, Louisville health officials told Darcy Costello of the Louisville Courier Journal.

State health officials have advised anyone living in Jefferson, Bullitt, Hardin, Greenup, Carter and Boyd counties, where the outbreak has been concentrated, to get a vaccination.

Officials also advise shots for anyone at high risk for getting the disease, including people who use illegal drugs, people who are homeless or have unstable housing, men who have sex with men, people recently in jail or prison and people with underlying liver disease.

Boyd County residents have responded well to the call, Erin Crace, nurse supervisor at the Ashland-Boyd County Health Department, told Kentucky Health News in a telephone interview. She said the agency vaccinated more than 100 patients a day in mid-April, and the number has dwindled to about 10 to 15 per day.

The department has also reached out to food-service workers to get them vaccinated. As of May 15, six Boyd County food workers have been diagnosed with the disease, the Lexington Herald-Leader reports.

Hepatitis A is found in the feces of people with the disease and is most frequently transmitted by eating or drinking something that has been contaminated with fecal matter -- typically because the food or beverage has been handled by someone with the virus who hasn't properly washed their hands after going to the toilet or changing a diaper. It can also be spread when someone with the virus shares a cigarette, drink or towel, or through sex, drinking contaminated water, and illicit drug use.

So far, most of the state's cases have been among the homeless and drug users, according to the Kentucky Department for Public Health.

A person can get the hepatitis A vaccine in a number of places, including health departments, pharmacies and primary-care providers, but Crace recommends calling first to make sure they have the vaccine in stock before you go.

Because of rules for storing and handling the vaccine, which expires, many primary-care providers, especially in low-risk counties, don't always have the vaccine on hand, and pharmacies might be more likely to have it, Crace said.

She added that the supply of vaccines will also vary among health departments, but the health departments in Boyd, Carter and Greenup counties were well stocked.

Crace said the Ashland-Boyd County department is able to vaccinate children and most people with insurance as well as those who are uninsured or under-insured. It can also offer the vaccine for a cash price. It offers a walk-in clinic between 8 a.m. and 9 a.m., and appointments as available for the rest of the day. It is open Monday through Friday.

A new state regulation requires students to have had the two-dose hepatitis A vaccine by the first day of school, but Crace said the department hasn't vaccinated many children recently, because many of them have already received it; it is offered at 12 months of age and older.

The most common symptoms of hepatitis A are fatigue, low-grade fever, loss of appetite, joint pain, sudden nausea and vomiting, yellow eyes or skin, abdominal pain, pale stools and dark urine, according to the Centers for Disease Control and Prevention. A person with the virus is contagious for up to two weeks before showing symptoms. Symptoms usually last less than two months, but 10 percent to 15 percent of victims remain sick for up to six months.

State health department declares outbreak of hepatitis A, a liver disease that is often transmitted due to poor sanitary practices

State and local health officials are working to contain an outbreak of hepatitis, comprising 31 cases in 13 counties, largely in the Louisville area but also from Paducah to Hyden.

The state Department for Public Health has declared an outbreak of acute hepatitis A, it said in a Nov. 21 news release. The number of cases is "a 50 percent increase above the average of 20 cases per year reported over the past 10 years," the release said. "Jefferson County has had 19 confirmed cases, most of which have occurred since August. Cases have been reported in Jefferson, Shelby, Bullitt, Hardin, Henry, Anderson, Mason, Christian, Madison, Fayette, McCracken, Hopkins, and Leslie counties."

  

The release added, "Common risk factors of homelessness or drug use have been identified among 12 of the cases in Jefferson County."

No deaths have been attributed to the outbreak, but “Acute hepatitis A is a serious and potentially life-threatening infectious disease,” said Dr. Jonathan Ballard, the state epidemiologist. “We are working to identify anyone who has been exposed to cases associated with this outbreak and urging those experiencing symptoms of the illness to contact their healthcare provider for appropriate evaluation and medical treatment, if necessary.”

Testing has suggested that the strain of hepatitis involved is one associated with outbreaks in California.

Hepatitis A, a liver disease, can be prevented by vaccinations. Children, ages 1 through 18 are recommended to get the vaccine, “as well as adults with increased risk factors or certain medical conditions,” Ballard said. Those factors include homelessness; all forms of substance-use disorder; people with direct contact with someone who has Hepatitis A; travelers to countries where hepatitis A is common; men who have sexual contact with men; household members or caregivers of a recent adoptee from countries where hepatitis A is common; and people with clotting factor disorders, such as hemophilia.

"Other than age-appropriate vaccinations, the best way to keep from getting Hepatitis A is to wash your hands using warm water and soap, to handle uncooked food appropriately and to fully cook food," the release says. "Always wash your hands before touching or eating food, after using the toilet and after changing a diaper. When soap and water are not available, use alcohol-based disposable hand wipes or gel sanitizers."

The signs and symptoms of Hepatitis A include yellowing of the skin or eyes (jaundice), dark urine, fatigue, abdominal pain, loss of appetite, nausea, vomiting, diarrhea, gray stools and fever. Not everyone with the virus has symptoms.

"The virus is found in the stool of infected people is usually spread from person to person by putting something in the mouth (even though it might look clean) that has been contaminated with the stool of a person infected with Hepatitis A," the release says. "It is often transmitted when people do not wash their hands properly or by eating uncooked or undercooked food."

Information about Hepatitis A is available from the federal Centers for Disease Control and Prevention at https://www.cdc.gov/hepatitis/hav/index.htm.