Ambulances shuttled patients out of a West Baltimore nursing home yesterday, after state health officials declared that poor medical care there threatened the patients' health and safety.
Acting Health Secretary Nelson J. Sabatini ordered the sickest and most fragile patients transferred from Hilton Hall at 3313 Poplar St. to other nursing homes more capable of caring for them.
His actions followed a lengthy inspection in late April and early May that documented mishaps involving 60 of the home's 126 patients.
"I don't feel that the people who are most fragile and vulnerable are going to get the care that they need, and I've got to get them to a place that's safer," Mr. Sabatini said.
Ambulances were due to transport nine patients to other nursing homes yesterday, and officials said they expected several more to be transported over the weekend.
Many of the problems involved elderly patients who were given too much or too little of the anti-seizure medication, Dilantin. Several were admitted to hospitals with toxic levels of the drug.
Another patient, according to inspectors, suffered internal bleeding when he received excessive doses of a blood-thinning drug intended to dissolve clots in his leg.
Inspectors also documented the case of an 88-year-old man who gained 20 pounds in 20 days as he swelled with fluids from congestive heart failure. Nurses waited several days to notify the patient's physician of his rapid weight gain, the inspectors said.
When the physician finally found out, they said, she failed to prescribe a high enough dosage of a drug needed to flush fluids from the patient's body.
Finally, the resident began hallucinating and was transferred to the hospital where he died from complications of pneumonia. The inspection report did not say, however, whether the patient's pneumonia or death was caused by mistakes at the nursing home.
hTC Besides ordering the transfer of the sickest patients, Mr. Sabatini disqualified Hilton Hall from the Medicaid program, which pumped $2.1 million into the nursing home last year. The flow of money will continue for some time, however.
Owners have until May 26 to convince health officials that they erred in disqualifying Hilton Hall from Medicaid.
Also, they have that same amount of time to make substantial improvements and earn the right to get re-certified for Medicaid.
"I'm going to have to be convinced that not only can they correct the problems, but also sustain performance and guarantee that," Mr. Sabatini said.
His comments reflected a long history of problems there.
Current ownership records on file with the health department list three owners: Frederick I. Greenberg and Melvin Thomas of Baltimore, and Philip Greene of Davidsonville.
Attorney Michael Kandel, who represents the home, refused to say if all three still own the home today.
"They intend to take steps to correct the problems," he said of his clients. "They've been taking corrective steps for the past 10 days."
Mr. Greenberg, Mr. Thomas and Mr. Greene owned the nursing home from the late 1970s until August 1989, when they sold it to Dr. Mark Davis and his wife, Vita Davis, both of Ellicott City.
Two years before the sale, the state threatened to cut off their public funding because of lapses in patient care.
Last November, the health department terminated Hilton Hall's public funding and removed more than 20 fragile patients after declaring conditions unsafe.
The home was placed under the management of a court-appointed receiver, and Medicaid was restored when Dr. Davis sold it back to its original owners.
The home was known as Poplar Manor until its resale in late December.
Rick Commack, a consultant brought in to correct the problems there, said he recently replaced a large number of nurses and aides in hopes of preventing future mistakes.
He acknowledged that some patients were at risk and should be transferred, but added: "The safety of our patients is foremost in our minds and it will be restored."