State health officials have launched an investigation after scabies was discovered in a Wilmington nursing home’s dementia unit, leading to more than three dozen patients being treated.
That same nursing home, the 142-bed Woodbriar Health Center, was already under scrutiny after a patient was dropped Christmas Day. The patient died two days later.
Woodbriar’s owner, Synergy Health Centers, has been beset by reports of substandard care — festering pressure sores, medication errors, poor infection control, inadequate training, and short-staffing.
Families of the roughly 40 Woodbriar residents in the dementia unit were notified in early January that at least one resident had scabies and that, as a precaution, everyone would be treated for at least two to three weeks with oral medication.
Scabies is a microscopic mite that spreads by direct contact with an infested person’s skin, or contact with their clothes or bedding.
Scott Zoback, spokesman for the Department of Public Health, confirmed that a state investigation of the episode is underway. He declined to provide details of the review.
As the mites burrow under the top layer of skin to feed and lay eggs, itching and a rash result, according to infection control guidelines posted on the state health department website. It can take two to six weeks for symptoms to appear in people who have never had scabies before
Synergy Health Centers, the New Jersey company that owns Woodbriar and 10 other Massachusetts nursing homes, said in a statement that one Woodbriar resident who had a “suspicious rash” tested positive for scabies following a skin scraping at a local dermatologist.
The statement did not address how the resident became infested with scabies, but said other residents and staff were treated according to established guidelines.
“No other individuals were found to have the condition,” the statement said. “A [state health department] surveyor reviewed the case during a site visit on Jan. 12 and identified no concerns for further action, stating that the situation was properly handled by the facility.”
Scabies infestations in nursing homes are not common, said Pat Fried, a former manager in the state health department’s division that inspects nursing homes. Fried said the department would not typically send a surveyor to investigate a scabies infestation unless the department had received multiple complaints about how the nursing home was handling the situation.
“The bottom line for all of this is . . . once [Woodbriar] discovered it, did they take it seriously and try to identify it, and prevent the spread, and treat it?” Fried said.
The daughter of one of the residents said administrators at the facility have provided limited, and sometimes conflicting, information about the problem. She asked not to be identified because she worries it might affect the quality of care her mother receives at Woodbriar, although she said her mother’s nurses have been terrific.
A Woodbriar staffer called the woman in early January to alert her to the scabies concern. When the woman visited the nursing home two days later, she was surprised to find all of the dementia unit residents dressed in hospital gowns because their clothes had been taken to be sanitized.
Eight days later, the residents got their clothes back, the daughter of the resident said. But then, without explanation, the clothes disappeared again for roughly a quarter of the residents, whom the facility deemed to be on a “watch list” because they had skin irritation resembling a rash, she said. And those residents were given another week of medications used to kill parasites.
Their clothes did not come back for another eight days.
“We literally got nothing concrete about any of this,” the woman said.
She said a sign went up at the unit’s entrance several days after families were alerted about scabies, instructing visitors to check with nurses before entering. But she said families never received information from administrators about whether visitors should be taking precautions — washing their clothes or not touching their family member’s skin while visiting — to avoid spreading the infestation.
“I’ve still had no official communication from Woodbriar that it’s gone,” she said. “That’s my question: What is the status of this?”
In addition to the scabies concern at Woodbriar, state health officials are still investigating the death of an 83-year-old resident. The woman was dropped from a mechanical lift Christmas Day when a certified nursing assistant improperly placed the resident in the lift while moving her from her bed to a wheelchair. The resident crashed to the ground, broke both legs, bled internally, and died two days later in a hospital.