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Fired nurse claims St. Cabrini Nursing Home patients died because of unsafe practices

Bill Heltzel by Bill Heltzel
August 28, 2020
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A nurse claims that St. Cabrini Nursing Home in Dobbs Ferry fired her because she opposed a scheme to defraud Medicare and complained about unsafe practices that have resulted in the deaths of multiple patients.

Cheval Smith, a registered nurse from Bridgeport, Connecticut, sued Cabrini under the federal False Claims Act, claiming retaliation, Aug. 11 in U.S. District Court, White Plains.

“Ms. Smith complained about and opposed several unlawful or unsafe practices at the nursing home,” the complaint states. “She was threatened with termination if she continued to complain about short-staffing, a practice which endangered patients”™ well-being. Shortly thereafter, Ms. Smith was terminated.”

Image via GoogleMaps

Cabrini officials did not respond to emails asking for their side of the story.

Cabrini is a 304-bed, nonprofit facility founded in 1973 by the Missionary Sisters of the Sacred Heart of Jesus. It is named for St. Frances Xavier Cabrini, the founder of the Catholic religious order who was canonized a saint in 1946.

The nursing home is rated below average on health inspections and on staffing, by the U.S. Centers for Medicare & Medicaid Services, based on an April 2019 analysis, but it is rated much above average on overall quality measures.

Smith has worked as a registered nurse since 2010, according to the complaint, and was hired by Cabrini as a nurse manager in 2018.

She claims that nebulization treatments, by which patients inhale medicines that have been turned into aerosols, were administered by licensed practical nurses instead of by RNs, as required by federal regulations.

In 2018 she was allegedly told to certify that she had performed a nebulization treatment. She refused, believing to do so was illegal, but relented when she was told “she would have to make these false certifications in order to keep her job.”

Shortly before she was fired on April 16, she was disciplined for failing to sign nebulization paperwork, the complaint states. When she was fired, Wynona Josephs, the director of nursing, allegedly mentioned her failure to sign the paperwork as a factor in the termination.

Smith connects the alleged nebulizer practices to staffing. Instead of two LPNs per nursing home unit, Cabrini assigned one per unit plus a second LPN to “float” between two units on a single shift.

She claims that she complained that short-staffing endangered patients. As the Covid-19 crisis developed, according to the lawsuit, “this floating arrangement became even more dangerous,” risking spread of the disease from unit to unit.

She also alleges that Cabrini provided insufficient personal protective equipment, did not require staff to change PPE between patient interactions, and declined her request to use disposable trays instead of reusable trays.

“Failing to adequately protect the safety and health of the patients and staff,” the lawsuit  states, “resulted in spread of the virus through the facility and the deaths of multiple residents.”

The complaint does not quantify how many Cabrini patients have been infected or killed by Covid-19.

Smith also claims that Cabrini solicited Medicare patients to become members of a health insurance plan operated by ArchCare, an affiliate of the Catholic Archdiocese of New York.

Cabrini staff were allegedly instructed to consult with and defer to an ArchCare nurse practitioner assigned to Cabrini. The nurse practitioner “generally refused” to approve hospitalizations of seriously ill patients, the complaint states.

When the nurse practitioner declined to authorize hospitalization for one of Smith”™s patients, Smith contacted the doctor on call, who “learning of the situation, ordered that the patient be hospitalized.”

Smith says she was reprimanded for circumventing the ArchCare employee.

In April, the ArchCare employee allegedly prescribed hydroxychloroquine for a patient who was symptomatic for Covid-19, but did not get a baseline EKG test to check for potential cardiac complications associated with the drug.

Smith confronted the nurse practitioner at a staff meeting, according to the complaint, and accused her of acting unethically and unsafely. The nurse practitioner complained to Josephs, the director of nursing, and several days later Josephs fired Smith.

Josephs, along with the unidentified nurse practitioner and ArchCare are not named as defendants.

Smith is demanding that she be reinstated on her job with back pay and is asking for damages for emotional distress.

She is represented by Manhattan attorneys Jason L. Solotaroff and Amy Robinson.

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