Night-nurse nightmare

LPN with criminal past is in trouble again, as an
by: Jim Clark, 
Margaret Barber is visited by husband Harry Barber and daughter Estelle Lile at Providence St. Vincent Medical Center, where she was moved after allegedly being mistreated by nursing home nurse Carri Lynn Borks.

Margaret Barber is afraid to return to her nursing home. Barber is 81 years old, a victim of a stroke 10 weeks ago and victim of something else - nobody's certain exactly what - in the early morning hours of May 24.

At 4:30 a.m. that day Barber was taken by ambulance from the Pearl at Kruse Way nursing home in Lake Oswego to Providence St. Vincent Medical Center.

She was bleeding from the area around a feeding tube in her stomach. But when her two daughters arrived at the St. Vincent emergency department, it wasn't the feeding tube or the ambulance ride or even her pain that Barber wanted to talk about.

It was the night nurse at the Pearl, who Barber said had verbally abused her and accused her of intentionally pulling out the tube.

As far as Barber's two daughters are concerned, that nurse, Carri Lynn Borks, also known as Carri Lynn Baker, should not have been caring for their mother or anybody else. And, they say, it shows that there are gaps in the system allowing abusive nurses to continue working.

Borks, 38, pleaded guilty in 2004 to two different drug-possession charges, was arrested several other times on drug-related charges, and was found in 2001 to have physically and verbally abused patients at a Grants Pass nursing home.

Borks, who has not returned calls to the Pamplin Media Service, also is awaiting arraignment next week on May 1 charges for methamphetamine possession.

Despite the criminal history, the Oregon State Board of Nursing renewed Borks' nursing license in April this year.

According to board officials, it is not their job to give potential employers information about a nurse's criminal history or past professional wrongdoing.

Meanwhile, officials with the Pearl say they did not do a criminal background check on Borks but relied on information about Borks' nursing license on the nursing board Web site and a background check that they believed the state Department of Human Services was doing on Borks.

Borks, a licensed practical nurse, was the night nurse at the Pearl - meaning she was the only nurse on duty - when Barber's feeding tube became dislodged and she began bleeding.

Nobody knows what happened that night. Barber may have rolled over on her side and dislodged the tube herself.

But according to Estelle Lile, Barber's daughter, a physician at St. Vincent wanted to know if her mother had suffered any trauma that might explain both the bleeding from the tube and swelling and bleeding on Barber's arm.

'We don't know how it happened,' Lile said. 'That's the scary part. She had some rough treatment somewhere.'

'When we got to the hospital all my mom could do was talk about this nurse,' said Nora Biege, Barber's other daughter. 'She just wouldn't settle down.'

Barber said she doesn't know what happened to her feeding tube, but she remembers the verbal abuse she said she suffered that night at the Pearl.

Barber, who is bedridden, said that she woke up in the middle of the night and called for Borks.

'I said, 'There's blood,' and she said, 'You pulled out your feeding tube on purpose,' ' Barber said.

Lile said Borks called her to say Barber was being taken to the hospital. When Lile called back, Borks was in Barber's room and Lile said she heard her mother's voice in the background.

'I heard my mom in a panic, 'Why would I do that? Why would I do that?'' Lile said.

Later on the morning of May 24, convinced that her mother was stabilized at St. Vincent, Biege headed over to the nursing home. She said she confronted Borks, who refused to talk with her. However, three nursing assistants who had been on duty confirmed her mother's story of verbal abuse, Biege said.

'The other people there were horrified at the way she was being treated,' Lile said.

This was not the first time Borks was accused of mistreating a patient. In 2004 a state investigator found that Borks had a history of verbally berating and humiliating residents at Highland House, a Grants Pass nursing home, in situations remarkably similar to the abuse alleged by Barber.

A complaint to DHS charged that Borks yelled at the patient because her colostomy bag came apart and began to smell, and that while others tried to help the patient, Borks forcefully ripped off the tape and bandage covering the patient's incision for the bag.

The DHS report says Borks continued to work at the nursing home until December 2001, after she was observed to be confused, staggering and 'displaying unsafe medication practices.'

Complaint has an effect

Biege is more than an angry daughter. She said she also runs an agency that helps families place their elderly in nursing homes and assisted-living facilities. She was determined to learn more about the nurse.

She ran a Google search on Borks, which came up with one item - a story that ran in the Portland Tribune 14 months ago detailing failure by the nursing board to keep tabs on the nurses it licenses and disciplines.

Borks was in the story because of her history, and because she had never been disciplined by the nursing board.

Biege next ran her own online license verification check on the nursing board's Web site. The site showed and continues to show Borks has a clean record - not a hint that there could be a reason to check further.

Biege said she then called the nursing board and filed a complaint alleging Borks abused her mother. She also told administrators at the Pearl what she had learned about the nurse's past.

Two days later, administrators at Avamere Living, the parent company that runs the Pearl and 38 other care facilities in Oregon and elsewhere, told Biege and Lile that Borks was no longer working at the Pearl.

Avamere Living President Judy Jackson told the Pamplin Media Service last week: 'We completed our investigation relative to the accusations of abuse, and as a result of that (Borks) is no longer employed with us.'

Record came as a surprise

Biege said she asked administrators at the Pearl why they had hired Borks. She said their answer astounded her.

'They obviously did not know she had a record,' Biege said. 'That's what we were told. It was a surprise to them.'

Biege said she spoke to an administrator who said she was in charge of nurses.

'She was just appalled she couldn't find a way to find out about these things,' Biege recalled. 'She jokingly said, 'What do we have to do? Google everybody to find out about these things?''

Bob Schneider, chief executive officer of Avamere Health Services, said that when Borks was hired the Pearl administrators checked her license with the nursing board and consulted with the state Department of Human Services for what Schneider calls 'a background check.' DHS investigates complaints made about nursing homes.

'They (DHS) gave her permission to work,' Schneider said. He also said that DHS told Avamere that a more thorough check would take months and that Avamere has not yet received it from DHS.

But Avamere was not completely unaware of Borks' history. Schneider said that at some point Avamere became aware of a conviction for drug possession in Borks' past. He said he did not know when they learned of the conviction and would not elaborate.

Schneider said his facilities mostly rely on the license verification page on the nursing board's Web site before hiring a nurse.

Due diligence required

Barbara Holtry, spokeswoman for the nursing board, said the board does criminal background checks every time a nurse applies for or renews his or her license.

She said she could not comment on what, if anything, nursing board investigators found in Borks' background before the board renewed her license.

Responding to Schneider's suggestion that employers rely on the nursing board information, Holtry said: 'We do not tell someone if they should or should not hire someone. Any licensure board does not replace the employer's responsibility to do due diligence.'

Mary Gear, DHS administrator for the office of licensing and quality of care, refuted Schneider's claim that DHS officials gave Avamere 'permission' to hire Borks.

'We can provide information about what might come up on a criminal history check,' Gear said. 'It's the facility's responsibility to gather information and make a decision about whether or not to hire.'

The Pearl had good reason to make that decision carefully. The nursing home has a history of drugs being stolen from the facility.

In February, Adult Protective Services in Clackamas County came in and required the Pearl to change the locks on its medicine cabinets because the facility couldn't identify who had been stealing drugs there.