November 18, 2007 in City

Despite woes, new nursing home approved

By The Spokesman-Review
 

Fines, letters

» Here are the fines and letters of enforcement for long-term care facilities in Spokane County, issued by the Residential Care Services unit of the state Department of Social and Health Services. The department inspects long-term care facilities for the Centers for Medicare and Medicaid Services and licenses them for the state.

» Records were collected from the fall of 2006 through September and don’t include enforcement actions listed in last year’s Spokesman-Review stories on local facilities.

Assisted living centers

Colonial Court

July 18 – Fined $100 for failing to ensure the safety and well-being of a resident and failing to provide services consistent with service agreement.

Park Place

Retirement Community

• Jan. 24 – Fined $200 for failing to ensure that staff reported instances of possible abuse or neglect that occurred with two residents in the memory care unit.

Sullivan Park

Assisted Living

Nov. 17, 2006 – Conditions placed on license for failing to ensure a system that would promote safe medication services for four residents.

Jan. 19 – Fined $500 for failing to promote safe medication services for two residents, placing them at risk of serious harm.

Aug. 23 – Modified conditions placed on a license for failing to ensure that the medication distribution system promoted safe medication services for four residents, causing harm to two people.

Waterford

Health Care Center

Nov. 1, 2006 – Fined $100 for failing to obtain prescriptions in a timely manner for one resident.

Nursing homes

Franklin Hills Health

and Rehabilitation Center

July 26 through Sept. 18 – Denial of payment for new Medicare and Medicaid admissions.

•Aug. 23 – Fined $3,000 for failing to ensure residents who lost weight received the necessary interventions to prevent further weight loss, resulting in harm to three residents.

Sept. 14 – Fined $1,000 for failing to ensure that a discharged resident was provided with a written 30-day notice prior to discharge. Fined $2,000 for failing to monitor, evaluate and provide nursing interventions for pain and skin issues, resulting in harm to a resident. Fined $3,000 for failing to relieve pressure, monitor wounds for healing and consult with physicians in a timely manner for a resident at risk for pressure sores. Fined $1,000 for failing to conduct thorough investigations, reports and take actions to protect residents regarding incidents of missing property, injuries of unknown origin and allegations of mistreatment.

The Gardens

on University

April 16 – Fined $5,000 for failing to provide medications as ordered by physician, resulting in harm to a resident. Fine was reduced to $4,000.

A long-term care provider received Washington state’s permission to build a 120-bed nursing home in south Spokane in spite of operating a facility that had the worst record in the county for resident care during the past year.

Franklin Hills Health and Rehabilitation Center, a north Spokane nursing home operated by Extendicare Health Services Inc., had extensive care deficiencies for the second straight year, resulting in enforcement actions by the state Department of Social and Health Services and the federal government.

Extendicare, of Milwaukee, Wis., owns or operates 189 facilities in the United States.

The most recent deficiencies at Franklin Hills were brought to light during The Spokesman-Review’s annual review of government enforcement records for assisted living and nursing homes. Inspections and letters of enforcement are posted on a searchable database at www.spokesmanreview.com/records/assistedliving.

Records collected from fall 2006 through September showed that a number of assisted-living centers fared better during the past year than the previous two years, although one facility, Sullivan Park Assisted Living, had ongoing problems with medication services.

Moran Vista Assisted Living, a South Side facility, had no state actions taken against it in the last 12 months. Moran Vista was fined four times between mid-2005 and mid-2006.

Cooper George Retirement and Assisted Living, which was fined five times from spring 2005 through fall 2006, also was free of any enforcement actions during the past year.

Northpointe Retirement Community and Parkway Village Assisted Living, both under new ownership, were also free of fines.

Alderwood Manor, a nursing home that had significant problems in 2006, was also free of fines and enforcement actions during the past year.

However, Franklin Hills stood out for deficiencies that led to $10,000 in fines and the near loss of a federal certification that enables the home to receive Medicare and Medicaid funds. Extendicare Health Services Inc. also owns The Gardens on University in Spokane Valley, and Ivy Court and Lacrosse Health and Rehabilitation Center in Coeur d’Alene.

The problems at Franklin Hills indicate a failure in the systems put in place to deliver care, said Shirlee Steiner, regional administrator for DSHS Residential Care Services Region 1, which serves 11 Eastern Washington counties.

“I would say they are struggling more than most places are,” Steiner said.

Her department, Residential Care Services, inspects nursing homes for the Centers for Medicare and Medicaid Services and inspects all long-term care facilities for licensing.

Jared Elliot, area vice president for Extendicare, said in a statement: “We identified Franklin Hills Health and Rehabilitation Center as a facility that was not consistently meeting our standards and began an intensive training and oversight program. In addition, we have a new, highly experienced leadership team in place and all staff has been re-trained on our policies and procedures.”

The company hired independent contractor LTCQ Inc. to monitor quality, evaluate improvement and assess practices and protocols, Elliot said, adding that the company dedicated significant resources and developed a quality improvement plan for all Washington facilities.

Franklin Hills’ problems in 2006 included $4,500 in fines for care issues, and the federal government’s denial of payment for new Medicare and Medicaid admissions plus a stop-placement order.

In spite of those care issues, in June the state Department of Health granted Extendicare permission to build a $14 million nursing home in south Spokane.

Janis Sigman, program manager for Certificate of Need, which determines whether nursing homes should be allowed to build or expand, said she was one of several people to review the company’s request. Extendicare once operated a south side home called Southcrest that it closed in 1999. The voluntary closure enabled the licensee to bank the rights to those beds in Spokane County for eight years. According to the report on the decision, the state was aware that four of the 15 nursing homes that Extendicare operates in Washington have noncompliance deficiencies surpassing the state average.

Part of the reason state officials were comfortable approving the Certificate of Need for the new facility, Sigman said, was that Extendicare planned to bring in an upper manager with a solid track record for overseeing nursing homes. Mel Beal, area vice president for Ohio and West Virginia, has been spending at least one week per month working with a leadership team in the region on operational plans for Washington facilities, said Holly Gould, spokeswoman for Extendicare.

In addition, Elliot became Extendicare’s area vice president in July and has more than 10 years experience in long-term care operations and a “history of strong clinical performance as well,” Gould said.

Sigman said the state randomly selected 10 facilities that Beal oversaw in Ohio and found that all showed improvement under his management.

“We take into consideration the entire operation of all of the facilities,” she said.

The planned South Hill Nursing and Rehabilitation Center wouldn’t open until 2010, Sigman added.

Residential Care Services inspectors did notice some improvement at Franklin Hills during a recent inspection, Steiner said, although she couldn’t give specifics because the report is being drafted and Extendicare hasn’t been notified.

“They (Extendicare) have put a lot of their corporate resources into this facility,” Steiner said.

But achieving compliance can be a long road for care facilities and inspectors will continue to closely monitor Franklin Hills.

“Hopefully that facility is going to turn around,” Steiner said. “But they are on our radar.”


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