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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Despite woes, new nursing home approved

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

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.”