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Mental health throwaways

Copyright © 2016 Albuquerque Journal

LAS VEGAS, N.M. – At the L&M Boarding Home for men, four residents sleep in an old travel trailer, a pillow plugging an opening to the outside next to an air conditioner. Eight others sleep in a series of connected rooms at the back of the home, many without doors and some with exposed wiring. One sleeping area is narrower than a standard jail cell.

The 12 tenants, who pay $550 a month each for a place to live and eat, share a single-stall shower. There is a collection of old sofas and chairs outdoors, where the men pass much of their time. Several residents were gathered there on a recent afternoon, most of them disheveled and some sharing a bottle of liquor. Other tenants were asleep in their beds.

Most, if not all, of the residents of the L&M Boarding Home are former patients at the New Mexico Behavioral Health Institute in Las Vegas, the state’s only public psychiatric hospital.

Workers for the state Office of the Long-Term Care Ombudsman and the Division of Adult Protective Services have investigated conditions at the boarding home, and police and emergency medical personnel are frequently called there to deal with fights, injuries and illnesses among residents.

Still, Linda Gutierrez, who owns the L&M Boarding Home along with her husband, Marvin Sena, says she runs a “good home” – one where she does what she can for the residents and she says the men are happy. “A lot of these guys have nowhere to go. We don’t want them on the street,” says Gutierrez, who also houses men at a second home nearby.

L&M is one of several boarding homes in the Las Vegas area that cater to men and women released from the Behavioral Health Institute. Each year, the hospital discharges about 200 patients into Las Vegas and surrounding San Miguel County.

A Journal investigation found that residents of some of the boarding homes live in crowded conditions and may go hungry because of inadequate meals provided by operators. Reports have also been made of verbal and physical abuse and financial exploitation, as well as violence and drug abuse by residents.

Two men released from the Behavioral Health Institute died of carbon monoxide poisoning in 2013 at a boarding home where they were paying a total of $1,100 a month to live in a backyard shed without plumbing.

Many of those released from the hospital receive about $750 a month in Social Security benefits because of their disabilities. Living in a boarding home eats up most of that.

While some Las Vegas-area boarding homes have been criticized in reports by the Office of the Long-Term Care Ombudsman, a few have been praised.

Minimal licensing

Few of the boarding homes in Las Vegas have city business licenses, which require fire safety inspections when first issued but not upon annual renewal. Las Vegas Mayor Tonita Gurule-Giron declined to be interviewed for this story.

Also, only one of the boarding homes in Las Vegas identified by the Journal has a state permit to maintain custody of prescription drugs, although many of the homes store residents’ drugs and pass out the medications. The lack of permits and the record-keeping they require raise the possibility of drug diversion by operators.

No one knows exactly how many boarding homes exist in the Las Vegas area, where they all are located, and what kind of living conditions they provide, because the state Health Department no longer regulates them.

Through local and state records, the Journal identified about two dozen boarding homes that are operated or have operated in Las Vegas and nearby communities in recent years.

The state Office of the Long-Term Care Ombudsman, which advocates for residents in long-term care facilities, has reported that living conditions in some boarding homes are much better than others.

But the ombudsman office doesn’t have the authority to require changes, and its investigators stopped visiting the homes in recent years, because of the lack of state regulation and the resulting inability to force operators to improve conditions.

Adult Protective Services, which investigates complaints of abuse, neglect and exploitation of vulnerable adults, also can’t force changes at boarding homes.

Whether it has ever substantiated a complaint against L&M or any other boarding home in the Las Vegas area is unknown, because its investigation records are confidential under state law. Court records show no legal action by Adult Protective Services against L&M.

L&M Boarding Home has a city business license but not a custodial drug permit from the state Board of Pharmacy. Gutierrez, who says she stores prescription medications and dispenses the drugs to residents, says she formerly had a permit but no longer does because she believes she isn’t required by law.

According to the Board of Pharmacy, a facility is required to be licensed by the board if it provides care for two or more unrelated residents and maintains custody of residents’ prescription drugs. Records for the receipt, administration and disposal of prescription medications are required to be kept for three years. A facility must also have a consulting pharmacist, who is required to review medication administration records.

Other homes

Documents obtained from the state Office of the Long-Term Care Ombudsman have raised concerns about other boarding homes in the Las Vegas area.

In an interoffice email in 2014, a health care surveyor for the ombudsman office wrote that a woman who runs a store near a boarding home reported that residents of the home were coming in and asking for food.

Residents reportedly told the store operator they received a bowl of rice for lunch and were told to bring back food from a senior center if they wanted more to eat. The woman also said residents told her they were limited to baths three times a week and had to use the same bath water as the previous person.

The woman told the ombudsman surveyor that she contacted Adult Protective Services but it declined to get involved.

In another report, an ombudsman surveyor said she visited a boarding home in the small community of Anton Chico in 2013 and found “10 men, all very thin. All wearing the same sweatshirt each in a different color. All in the same small room watching television.”

In a 2010 memo about the same boarding home, an ombudsman surveyor wrote, “Residents may be financially exploited. … Residents may be hungry.”

The surveyor also said a social worker had been denied access to clients at the home and that a report by Adult Protective Services “validates verbal abuse of residents (by the home’s operator), the apparent fear the residents have of (the operator) and issues re: the residents receiving adequate food.”

After a visit in 2013 to a boarding home in Las Vegas, an ombudsman surveyor wrote that all of the six residents she talked to “reported they did not receive enough food and often went hungry. … They reported eating meals at the senior center. Dinner they get leftovers. Often beans and nothing else.”

Some boarding home operators serve as so-called rep payees, receiving the Social Security checks of their residents directly from the government.

At least two operators of boarding homes have been terminated by the Social Security Administration as rep payees because of misuse of beneficiary funds, according to documents obtained from the Office of the Long-Term Care Ombudsman.

No issues

Ombudsman surveyors reported no concerns in visits to some boarding homes.

“Residents said the food was good and they got to their physician appointments without issue. Rooms were clean. Towels, sheets, blankets, toiletries,” reads a report of a visit in 2013 to a boarding home in Ribera.

“Fully stocked kitchen and pantry. New heating and cooling system, new large flat screen TV, hot water working, bathrooms newly remodeled,” a surveyor wrote after a visit in 2013 to a home in Las Vegas.

At another boarding home in Las Vegas, residents reported in 2013 that they had a ferret and enjoyed taking care of it.

EVERHART

EVERHART

“There are really a small handful (of homes) that are trying to do a good job,” says Sondra Everhart, who served more than a decade as the state’s long-term care ombudsman.

The Department of Aging and Long-Term Services fired Everhart in June, saying she wrongly released documents to the Journal about visits to boarding homes by ombudsmen health care surveyors. Everhart is now suing the department.

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