Past and current residents of the Oxford Rehabilitation & Health Care Center in Haverhill say there are a range of problems with the facility that they've brought to the attention of management time and time again, yet they get little satisfaction.
From bed bugs to stained carpeting to a perceived lack of staff, they say the Oxford is overdue for improvement.
"It's a hard place to deal with," said Daniel Muise, 53, who spent more than two years at the Oxford recovering from multiple knee replacements and knee infections.
Muise, who lives in Haverhill, said he was forced to leave the Oxford in August, but while living there he posted numerous videos on Facebook about his experiences. He called his videos "Dan TV," and said they upset officials at the facility.
"The building's administrator, a young woman, didn't like me because I recorded videos of me complaining about things," Muise said. "I didn't do anything wrong. I considered myself an advocate for myself and other patients."
Muise said his concerns included shower stalls without pull chains for alerting staff in the event of a fall, and a back door that was rusted with holes with an automatic door opener that did not work. Carpets in the entry area were stained and unclean, he said.
"A pet rabbit that staff cared for was allowed to roam around, soiling the carpeting in the front lobby," he said. "It was disgusting and can't be a healthy thing."
Concerns about the facility were heightened after an assault there on the evening of Oct. 5 that resulted in a patient's death.
Police said Jose Veguilla, 83, swung a walker and hit his roommate, Robert Boucher, 76, several times as he was lying in bed, causing injuries to Boucher's face and head. Boucher was taken to the hospital, where he was pronounced dead.
Veguilla was charged with murder.
Tim Brown, director of marketing and communications for Athena Health Care Systems, which manages the Oxford, said the facility is part of an industry that is "highly regulated by federal, state, and local agencies, all of which we work with in a collaborative manner as we strive for the best care for our patients and residents."
Responding to concerns expressed by residents, Brown said some upgrades to the building were in progress as of two weeks ago.
"The physical plant currently allows for the normal and safe operations of our center, delivery of care, and our residents’ participation in activities and programs," he said. "However, we will perform certain physical plant upgrades to enhance the facility, including carpet replacements beginning today (Oct. 11)."
He added, "We will not comment on historic issues and events that have been fully resolved and addressed."
He also refused to allow a reporter to tour the Oxford.
Marybeth McCabe, a spokeswoman for the Massachusetts Department of Public Health, said a criminal investigation is being led by local law enforcement in consultation with her agency. She said her department has no authority to independently investigate allegations of criminal wrongdoing.
McCabe said the Oxford reported the incident that led to Boucher's death to the department the day it happened, and state officials initiated an unannounced inspection to look into the reported incident and assess the facility’s compliance with state and federal regulations.
She said the department's oversight is focused on the care it provides, and to that end, the department investigated to ensure the safety of the Oxford's residents.
"At this time, the investigation is still considered to be open and ongoing, so no additional details can be shared," she said following the Oct. 7 visit.
Ex-Oxford patient Daniel Muise was one of several current and former residents, and members of their families, who raised concerns about the facility's upkeep.
Muise said on several occasions when he was trying to take a shower, he bumped into wheelchairs and other apparatus stored in the shower stall.
He said the stalls were often unclean as well.
"If you're going to run a business, you need to ensure everything is disinfected and clean," he said, noting that he brought his concerns to an ombudsman.
"On another occasion, when I was told I could not leave the building, the ombudsman helped me get permission to leave," he said. "The ombudsman was great and every time I called him, he helped me."
Muise said that as of Tuesday, Oct. 15, he was a patient at Massachusetts General Hospital being treated for another knee infection.
"After learning about the murder at the Oxford, I'm thinking the staff there will be trying to make things better so the world outside doesn't really see what's going on," he said.
Mary McKenna, a long-term care ombudsman for the state Executive Office of Elder Affairs, said she could not discuss actions involving the Oxford and its residents, and would only speak generally about her agency's work.
She said the agency advocates for residents of long-term care facilities. Ombudsmen make weekly visits to speak with residents about their concerns, which can range from something as mundane as cold coffee to more serious issues like sexual abuse.
The majority of ombudsmen are skilled volunteers — such as retired lawyers, nurses and teachers — who work out of 20 offices across the state.
"We are not regulatory oversight, we are a federally mandated advocacy program," she said. "What we try to do is mediate and bring to the attention to the facility an issue a resident has. A typical scenario is meeting with all parties involved."
Bed bug complaints
Debra Leno's brother Edward Shaw, 49, diagnosed with seizure disorders, has been a patient at the Oxford for almost two years.
Leno, who is Shaw's legal guardian, said an incident involving bed bugs in his room this past summer prompted her and her brother to complain to staff, the city's Board of Health and the state Department of Public Health.
"Because my brother is diabetic and has neuropathy, he didn't feel the bites on his legs," she said. "They bombed his room while he stayed with me, and when he returned, they said they were placing him back in his room, and I told them not to do that.
"I had to call the home office, and they finally moved his room," she said.
Leno said staff at the Oxford failed to follow through with a prescription change intended to better control her brother's seizures.
"It wasn't until a few weeks later that they found the new prescription on the back of his chart," she said. "And when he suffered a mini-stroke this summer, a nurse called me to say his mouth was drooping. I had to tell her to call an ambulance."
Leno said she's tried to place her brother in another health care facility, to no avail.
"My brother's former social worker wrote something about him being dangerous and in need of supervision, so no other facility wants to take him," she said. "Yet, he's not dangerous ... he just gets frustrated."
Leno said she interacts with an ombudsman as well, and that she's pleased with his help.
"He tells me he files reports, but then he gets no response so he encourages me to continue advocating for my brother," she said.
Shaw said the Oxford was visited by several representatives from the "corporate office," whom he met.
"I showed them photos on my laptop, including photos of ceiling vents with water damage, a back door to the patio that is rusted with jagged edges, and library and lobby carpets that are disgusting," he said. "I told them that if I owned this building, I'd level it, clean up the lot and erect a new building."
Shaw said, in his opinion, there is a lot of turnover among staff at the facility.
"Within a year they changed administrators five times, the director of nursing twice, the director of activities once, and two social workers left along with upwards of a dozen CNAs (certified nursing assistants)," he said. "Whoever starts working here, six weeks later they leave."
Shaw noted that on Friday, Oct. 11, six days after the assault that led to the death at the Oxford, workers were in the building to tear up stained carpets in the library and main lobby. They were also cleaning walls and repairing the elevator.
"State officials have been here all week, along with company officials," he said.
Brown, the communications director for Athena Health Care Systems, said the center is "always fully and appropriately staffed based on the needs of those we serve, 24 hours a day, seven days a week."
"We are grateful for their hard work and dedication to our patients and residents in such a challenging and important profession," he said.
Roger Lemire, 79, of Haverhill was a patient at the Oxford about eight years ago, while recuperating from spinal surgery, and also had concerns about the quality of care.
"After my surgery, I was supposed to receive medication every few hours, but they ran out and I had to wait about eight hours for the next delivery," he said. "For my first two days, they didn't have me listed in their meal program, so I had to call a friend to bring me take-out orders.
"The problems were corrected, but there shouldn't have been any problems at all," he said.
McCabe said that in addition to complaint-based surveys, the Department of Public Health routinely conducts surveys of licensed long-term care facilities to monitor resident safety and care. All surveys, whether routine or triggered by complaints, are unannounced.
Oxford Rehab and Nursing Home has a long-term care facility license issued by the state Department of Public Health. It is also federally certified by the Centers for Medicare and Medicaid Services.
The state may issue fines for what it deems to be non-compliance with state regulations. The federal agency may also issue fines for non-compliance.
If a resident of a facility, their representative or a family member has concerns about care, they may contact the facility’s long-term care ombudsman for assistance, or they may file a complaint with the Department of Public Health by calling 800-462-5540.