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MediCorp has given a plan of corrections to state officials
A resident watches television while a staff member cleans up breakfast dishes yesterday Vivien Mensah, LPN, works on paperwork in the hallway of Carriage Hill Rehabilitation and Nursing Center yesterday. MediCorp has filed a plan of correction with the state to address deficiencies in the facility. |
BY JIM HALL
Improved communication, tighter supervision and more training for the staff are among the changes proposed at Carriage Hill Rehabilitation and Nursing Center to restore its Medicare and Medicaid funding.
The changes are outlined in a "plan of correction" that nursing home officials filed with the Virginia Department of Health last week.
Nursing home officials said this week that they will test the improvements this month before inviting state inspectors to return to the Spotsylvania County home for a new review.
"We will call and request a survey when we feel we're ready," said Nicole Threatt, new administrator at Carriage Hill.
Carriage Hill was sanctioned by state and federal regulators last month after a series of inspections uncovered numerous problems.
The nursing home lost its federal Medicare funding, effective yesterday, and will lose its Medicaid funding, beginning Sunday.
The home receives funding from one of the two health insurance programs for nearly three of every four residents. Their loss will cost Carriage Hill and MediCorp Health System, its corporate parent, about $450,000 a month.
MediCorp officials told residents and families that they would keep the home open. They also said that that residents would not have to pay extra to cover the lost revenue.
"We're committed to becoming recertified," said Kathleen Allenbaugh, spokeswoman.
Unannounced inspections at Carriage Hill, beginning in December, found problems ranging from residents not getting the care their physicians ordered to equipment not working properly.
In addition, an 83-year-old resident died May 1 when he strangled in the nurse-call cord attached to his bed rail.
To correct these problems, Carriage Hill has proposed:
Holding a staff meeting each morning, to be attended by administrators, nursing leaders and other staff members, to review the health of residents.
This daily meeting was one of the first changes Threatt made when she arrived May 14.
"We would look at everything from the day before," Threatt said.
Spot checks by nursing leaders to make sure that state regulations are met.
For example, each week a nurse manager will review 10 percent of all patient records to see if physician orders are being followed.
Another spot check will make sure that patients' oxygen equipment is being changed weekly.
A third will involve weekly "wound rounds" to make sure residents don't have pressure sores.
Additional training for the staff. Classes in CPR, patient privacy, the operation of patient beds, the symptoms of depression, and the use of the call-bell system are among the training sessions that have occurred or are planned.
Changes to the call-bell system. Maintenance workers have attached the call-bell cords to bed frames with plastic ties.
Tieing of the cords shortens them and prevents staff, families and residents from looping them, Threatt said.
"It allows for the residents to still be able to use it," Threatt said. "It just does not leave any room for it to be wrapped around the side rail."
A resident strangled in a loop created by tying the cord twice around the bed rail. The death is still under investigation, said a spokeswoman for the Spotsylvania Sheriff's Office.
Carriage Hill is also considering purchase of a wireless call-bell system, Threatt said.
Carriage Hill had 146 residents last month during the state inspection. By Tuesday, the number had dropped to 126.
The number is lower, Threatt said, because the home cannot accept new Medicare or Medicaid residents. In addition, some residents have died and others have completed short-term stays.
"We have not experienced anyone who has said that they want to be moved to another facility due to the recertification issues," Threatt said.
MediCorp officials have told the staff that the reduced numbers will not result in layoffs.
"Some of our associates may be asked to go work in other areas in the company where there's high census until our census here comes back up," Allenbaugh said.
Jim Hall: 540/374-5433| New administrator
The problems at Carriage Hill were not because of a shortage of staff, said Nicole Threatt, the new administrator.
Rather, the home did not have key systems in place, and its staff was not following the ones it did have, she said. "People maybe had not been held accountable for the policies and procedures," she said. Carriage Hill has two registered nurses and three nursing assistants on duty during the day for each unit of 30 residents, she said. "I'm not real sure you're going to go into a nursing home and find any better than that," Threatt said. Threatt, 36, is a native of Chesapeake and a former nursing assistant. She graduated from VCU in 1992 and has worked for 14 years as a nursing home administrator in three states. She was administrator at Beverly LivingCenter's Petersburg home prior to moving to Carriage Hill last month. --Jim Hall |
