Trying To Make The Grade Nursing Home Prepares For Its Next Inspection

October 08, 1990|By JoAnna Daemmrich | JoAnna Daemmrich,Staff writer

A Glen Burnie nursing home that failed a routine state inspection for the second year in a row could become ineligible for Medicare and Medicaid support unless it receives a clean bill of health in the next few weeks.

Pointing to a new nursing staff and improved record-keeping, the director of North Arundel Nursing and Convalescent Center said she expects the 121-bed facility to pass a follow-up inspection with flying colors.

The private, 22-year-old nursing home on Hospital Drive has strengthened its reporting standards and replaced nurses contracted from outside agencies with its own staff, said administrator Shirley D. McKnight.

"Last year, we used agency nurses, and it really messed up our charts," she acknowledged. "They simply forgot to jot down what happened a lot of the time. But the patient care in this nursing home is very good."

In a correction plan submitted to the state Department of Health and Mental Hygiene, the nursing home outlined improved steps to investigate, document and follow up incidents in which patients suffer sudden medical problems or injuries, such as bruises from falling down or hitting the edge of a bed.

Health Department officials are reviewing the plan and intend to make an unannounced checkup of the nursing home in the upcoming weeks, said Carol Benner, the agency's acting director of licensing and certification.

An annual inspection in August found the center had a "diminished capacity to provide care," failing to meet federal standards for documenting and following up potential abuse.

"Nursing homes are expected to keep accurate records," Benner said. "We go by the theory that if a follow-up investigation of abuse wasn't documented, it didn't happen. It's strict, but those are the federal regulations."

North Arundel Nursing and Convalescent Center was cited for violating 36 regulations involving 39 patients, the state report said.

Incidents ranged from delays in informing physicians about injured patients to failing to adequately supervise a disoriented 84-year-old woman, who slipped and hit her head while she was being helped in the shower.

One of the most serious cases listed in the report involved a diabetic woman who continued to receive insulin shots, even though she vomited her food two days in a row. State health officials sharply criticized giving those injections because insulin "in the absence of food intake can lead to abnormally low blood sugar, coma, or death."

But none of the incidents was considered a serious threat to the patients' safety, Benner said. The state immediately shuts down nursing homes if investigators determine that the patients are in risk of neglect or mistreatment.

McKnight categorically denied that any patients had been mistreated or abused. Some nurses were lax in filing reports, but never failed to follow up problems, she contended.

"We have had no abuse in this nursing home," she said.

Nursing homes that fail to meet state and federal regulations risk losing their Medicare and Medicaid financing, Benner said.

Both programs to support the elderly pay nursing homes daily fees on a varying scale.

North Arundel Nursing and Convalescent Center currently is listed on a "slow termination track." If the nursing home fails to comply with the standards, it could risk losing its eligibility for Medicare and Medicaid financing.

McKnight, who criticized media reports for tarnishing the nursing home's reputation, said she has taken measures to guarantee proper and complete reporting.

"This has been blown way out of proportion," she said. "It's about documentation, not abuse."

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