Nursing homes questioned about emergency calls
INDIANAPOLIS - In life and death emergencies, we're told to call 911 to ensure a quick response.
But 13 Investigates has discovered parents, grandparents and other vulnerable loved ones being put at risk by Indiana nursing homes, who refuse to dial those three simple digits. One woman has already died.
The investigation uncovered an outrageous practice that allows nursing homes to call hired help miles away, instead of 911 responders around the corner.
Barbara Parcel traveled the world after spending years connecting calls, some of them emergencies. But when the former Indiana Bell telephone operator suffered a heart attack at Kindred Healthcare's Wildwood Healthcare March 5, a lax and little-known emergency guideline failed her.
"It seems to be a conflict doesn't it?," questioned Barbara's best friend, Elsie Britton.
Elsie was at Barbara's side the night in question and called nurses when her friend started gasping for air.
"When you call an ambulance, I expect them to be there shortly," she said.
But Elsie says the ambulance was a no-show. She was escorted out of the room and left to worry and wait for nearly an hour. There was no immediate ambulance ride from the nursing home to a nearby hospital, in time to save Barbara's life.
13 Investigates discovered the nursing home had never called 911, even though the closest paramedics were only five minutes away. Instead, Wildwood Healthcare called the private ambulance company it hired.
"It was a very poor decision," said Elsie.
Industry insiders tell 13 Investigates the first call to get Barbara Parcel help went to Care Ambulance around 8:15 that Saturday night. Care had just one crew working on the west side near Avon. That paramedic asked the Care dispatcher to call 911.
A 911 call would have sent firefighters from Station 43, just nine blocks from the nursing home, and the closest ambulance.
But Care scrambled another crew from its downtown headquarters still more than 20 minutes away. After Care arrived on the scene, a dispatcher finally decided to call Marion County EMS.
13 Investigates obtained that phone call:
Dispatcher: "Fire and Ambulance."
Care Ambulance: "I need a crew sent to Wildwood Healthcare Center. We do have a medic on scene. The patient is in cardiac arrest. They will need assistance."
Dispatcher: "We'll get you manpower on the way."
By the time Barbara got to the hospital, it was too late.
"I miss her very much and I wish she were here with me. I know she's looking down," said Elsie with tears welling up in her eyes.
As Barbara's friends and family grieve, 13 Investigates went looking for answers, first at Wildwood Healthcare. A man who identified himself as the director told us, "You have to leave the property. This is private property. I can't talk to you."
We were escorted out and told corporate administrators would contact us. At Care Ambulance, company spokesman Jason Howard spoke to us.
"We don't want to hide any of this. We don't want to make it a bigger issue than it's becoming. Ultimately, a patient died," Howard told 13 Investigates.
He refused to show us the company's response time records until Indiana's attorney general wraps up its investigation, but defended the crews actions.
"We got the appropriate personnel out there to best care for this patient at that time," said Howard.
"So you're telling me, leaving from this facility, going all the way to the east side, taking 20 minutes to get to a patient in cardiac arrest, when there was a fire department five minutes away, that that was the best response?," 13 Investigates Reporter Sandra Chapman responded.
"Our response times, we felt, fit into industry standards," Howard answered.
Later, Howard admitted that industry standards were eight minutes and that Care's crew time could have been nearly double that, but he wasn't sure.
"I'm really surprised that that is going on," Elsie Britton told 13 Investigates.
"It would not surprise me," said Rick Archer, the state's top investigator at the Emergency Medical Services Commission. The EMS Commission is the agency responsible for policing ambulance companies.
Archer confirms what industry sources tell 13 Investigates. Some nursing homes are calling their hired private ambulance companies for life and death emergencies, instead of 911, whether their crews are the closest or not. They've been doing it for years.
"I understand some nursing homes have some concern about calling 911, because of the disruption that having multiple responders come to the scene, has on their other patients," explained Archer.
You heard right. Nursing homes bypassing the closest life saving treatment because they don't want disruptions.
"It should make us angry," said Elsie Britton in disbelief.
"From an outside perspective looking in, that sounds bad, but there could be circumstances in which that was an appropriate response," Archer reasoned.
But how would the state know? Indiana has no rules for ambulance response times.
"There's nothing really at the state level from the State EMS Commission that says you have to send the closest ambulance," he revealed.
"There is no rule. They don't have to call the closest ambulance," 13 Investigates explained to Elsie Britton.
"That's something that needs to be changed. She should have had help right now, as quickly as she could," fired back Britton as she thought of her dear friend.
The American Heart Association says patients are most likely to survive cardiac arrest if they receive appropriate care within 4-6 minutes.
In response to our report, the EMS Commission has opened its own investigation. The paramedic who questioned the risky call has resigned over Care's handling of the call.
But Wildwood Healthcare is still refusing comment. Its parent company, Kindred Healthcare, provided the following statement:
"Resident care and safety is our number one concern. The facility has all appropriate policies and procedures in place related to patient care including those residents who experience cardiac arrest. Those policies are implemented as determined by medical professionals for the given patient at the time. The incident in question is currently under investigation. Due to regulatory constraints related to patient privacy we are not able to comment on any specifics."