WHAT STARTED AS A DISPUTE over a fired union organizer has turned into a fight over quality of care at Portland's largest nursing home, Laurelhurst Village on SE Stark.

Laurelhurst Village landed in the crosshairs of the Service Employees International Union, Local 503 (SEIU) last month after management fired employee Elizabeth Lehr just days after she became a union organizer at the facility ["Nursing a Grudge," News, May 7]. Lehr filed a complaint with the National Labor Relations Board and is asking for her job back. But in the meantime, union recruitment at the home has frozen and the fight between union and nursing home management has heated up.

When the union went digging through the nursing home's history, they found some alarming violations. At a community forum held on Tuesday, May 19, the union handed out a flyer listing Laurelhurst Village's health violations, discovered by federal government inspectors. The Southeast nursing home is among the 20 percent of Portland nursing homes currently rated at one star out of five for health inspections on the federal Medicare website, medicare.gov—the lowest rating possible.

A 2007 violation described a patient who suffered "a lot of pain and discomfort" after being unable to urinate for hours when a nurse forgot to insert a catheter. Another, from April 2008, says the nursing home skipped giving a patient a prescribed laxative. A physician reported that "massive amounts of stool had been removed [from the resident]" and that the patient was "vomiting stool."

"Overworked nurses cannot provide quality care," said Laurelhurst nursing assistant and union organizing committee member Andrea Glaser. In response to the union's flyer listing the horrific health violations, nursing home management distributed three flyers of their own headlined "The Truth" to nursing home employees late last week.

"The union that's trying to organize you passed out a flyer criticizing the quality of care that you, our valued employees, provide. Many of the things said by this union are simply wrong," the first flyer reads, going on to say that Laurelhurst Village's health inspection rating is two stars, not one. But as of this week, the government website shows that Laurelhurst Village's health inspection rating is currently one star.

On Friday, May 22, Laurelhurst Village looked clean and orderly as Director of Operations Hannah Austin showed off the nursing home's handsome new wing.

"Our campaign is not, 'Join a union, don't join a union.' Our campaign is information," Austin says. While acknowledging the facility's past health violations, Austin says Laurelhurst Village came away with zero violations from its most recent inspection in February, although the government has yet to release that inspection data on the Medicare website.

Austin also defended the nursing home's health record, saying that the nine violations from its November 2008 inspection must be viewed in the context of Laurelhurst being the largest nursing home in Portland, with 203 beds, according to Austin.

Portland's second largest nursing home, West Hills Health and Rehabilitation had only one violation for its 180 residents in September 2008 and Marquis Care at Mount Tabor had five health violations for its 175 residents in February 2009, according to the Medicare website. Indeed, despite Laurelhurst's troubling record, it does not currently have the most health violations in Portland—that dubious honor goes to Glisan Care Center on NE 97th and Glisan, which scored 15 violations in February 2009.

"That tells you right there that there's a problem with the way nursing homes are staffed in Oregon," responds Sara Routt of the SEIU, pointing out that Laurelhurst is symptomatic of a broader statewide problem. According to Austin, Laurelhurst Village meets the state's seven patients per nurse legal minimum, but nurse and patient advocates say the minimums are still too high to keep residents safe.

"Just meeting the minimum does not always provide adequately for patients' needs," says Bob Joondeph, director of Disability Rights Oregon.

At the community forum, a former Laurelhurst resident also spoke to the audience via video. "The nurses tried so hard and they never got any help from the management," recalled Donna Fitzgerald, a white-haired elderly woman who started to cry during the emotional video. "It's hard to be sick and watch people work so hard for so little."