Three nursing homes face fines for lapses in care related to residents who were injured or whose wounds were not properly treated.

In one case, the state Department of Public Health (DPH) cited Candlewood Valley Health & Rehabilitation Center in New Milford for failing to provide adequate care to a resident who refused medications and wound treatment for so long that her leg wound was found to be "infested with maggots," a state inspection report says. After the resident, who was diagnosed with dementia and depressive disorder, developed leg sores, she refused nursing care and medications, telling staff "I just want to die" and acting out aggressively.

According to the DPH report, a psychiatric evaluation last August recommended that the resident be transferred to an inpatient psychiatric facility. But an attending physician at Candlewood refused to sign an emergency certificate approving a psychiatric admission, saying the resident was not in imminent danger and would be harmed by being sedated and restrained, the report says.

The resident continued to refuse treatment at Candlewood, as her wounds festered. The nursing home was cited for failing to develop an alternative plan of care to address the resident's ongoing refusal of treatment. The DPH imposed a $1,020 fine.

In another case, Orchard Grove Specialty Care Center in Uncasville was cited for lapses in care involving a resident who sustained a pelvic fracture in a fall, and another resident who was not properly treated for constipation. That home also was fined $1,020.

In Meriden, Apple Rehab Coccomo was cited for two incidents, one in which a resident had a significant weight loss – 12.3 percent in three weeks – after losing his or her dentures. An assessment revealed the resident had trouble chewing, but the facility's dietician was not made aware of the problem, the DPH report says.

Another resident suffered an injury while being transferred from a bed to a wheelchair without the aid of a mechanical lift, as required in the patient's care plan. A nurse's aide was disciplined for that lapse, according to the report. The nursing home was fined $2,180 for the two incidents.

This story was reported under a partnership with the Connecticut Health I-Team (www.c-hit.org).