Despite Chronic Problems, State Approves Lakeview Rehab's Plan Of Correction

Feb 20, 2015

Lakeview Neurorehabilitation Center, Effingham, NH
Credit Conway Daily Sun/Jamie Gemmiti

The state has accepted a Plan of Correction from Lakeview Neurorehabilitation Center in Effingham, which means, for now, Lakeview’s doors wills stay open.

Last September the Disability Rights Center released two reports alleging many instances of neglect and abuse at Lakeview, and at that time Governor Maggie Hassan shut down new admissions to the facility. Lakeview cares for people with developmental disabilities and traumatic brain injuries.

NHPR’s Jack Rodolico discussed what's next for Lakeview on All Things Considered.

So what kinds of problems did Lakeview have according to the Disability Rights Center?

The DRC spelt out a number of sort of case studies of abuse and neglect – individuals who were repeatedly neglected and abused at Lakeview over the course of several years going back to 2011. And the state immediately followed up with a report that found that there was chronic understaffing at Lakeview, the staff were underpaid, that there was very poor communication between staff members. For example, a patient would be given a certain medication one day and then not given a medication the next day, overdosed on a medication [another day]. A bunch of different problems.

So initially Lakeview gave the state a Plan of Correction in the end of December, and the state rejected that Plan of Correction.

But the state has accepted this new plan, so what does Lakeview say it’s now going to do?

Right, well, we don’t know what was in that first one because it’s not open for the public, but this one is. And so they address a lot of these points specifically. They say they're going to bump up pay for lower staff. They are going to try to over-recruit staff – the same way that a school needs substitute teachers that are competent, Lakeview needs staff that are competent to deal with highly complex developmental disabilities and they need people on call to come in on short notice. They’re going to switch to electronic records so people aren’t writing down incident reports on paper, which are then handed off to another staff member. They’re going to try to redesign their training techniques.

But the really important thing that is in here is that – this is a quote from their Plan of Correction – they say, “We understand that the financial pressures to admit new participants cannot supersede the safety of those we serve.”

That seems to be an acknowledgement that these patients come with a big payload financially. They’re very expensive to care for, like $290,000 a year. So there’s a financial incentive there to take on more and more complicated people, and if you don’t back that up with staff, you can’t care for the people.

The big question then is: Will this plan be enough to fix the problems at the center?

We don’t know. Lakeview has been struggling with these problems for years. And it’s very hard to know if they’re going to be able to turn it around on a short-term or long-term basis. They’ve had opportunities in the past, and they haven’t been able to do it yet.

So what comes next then? Is Lakeview out of the woods now that this has been accepted?

They still have several big hurdles to jump.

For example, the Department of Education visited Lakeview in the last few months and they found some very major deficiencies with the Lakeview School. Lakeview has a residential facility, and they’ve got young people who go to school, but they also have a day school. [The Department of Education] essentially found that the school did not have written curriculum.

And you know the other big thing is that there’s a lawsuit pending, [and] potentially more pending lawsuits from family members that claim their children were abused there. And there’s yet another report that’s due out, sort of probing into other issues at Lakeview and what the state should or should not have done about.