One of Baltimore's largest nursing homes, the Golden Touch Care Center, will lose its state license to operate because of a historic failure to deliver quality health care to its sick and elderly patients, officials with the state health department said yesterday.
Inspectors with the Department of Health and Mental Hygiene said that the nursing and physician staff failed in many instances to give proper medication, treat crippling bedsores and consult with each other about the illnesses that afflict the home's residents.
The decision comes about a year after the health department ordered the transfer of 12 critically ill patients -- most of them diabetics -- from Golden Touch to other nursing homes because, in the words of state regulators, their health was in "imminent danger."
Since then, state health officials threatened the home with sanctions twice more, only to lift them after management made short-lived corrections. Finally, in August, Golden Touch failed its fourth inspection in 12 months.
And in a letter dated Sept. 19, Health Secretary Nelson J. Sabatini said that he decided to revoke Golden Touch's license because of repeated failures to bring about lasting improvements.
Moreover, he said that financial woes have hindered its ability to hire competent staff and stem a flood of staff turnover that has seen four administrators and five nursing directors hired and gone -- all in the last 22 months.
Recently, financial difficulties escalated to the point where employees were unable to cash their paychecks, and the nursing home was receiving all its supplies, including food and medication, on a cash-on-delivery basis, according to health department documents.
The Golden Touch administrator, Darrell Reich Jr., its owner, Leah Rama of Los Angeles, and lawyer, Henry Schwartz, could not be reached for comment yesterday. It was not known whether the Golden Touch management would exercise its right to appeal by Oct. 19, the date when the license revocation is due to take effect.
An appeal would temporarily suspend the state action and put the matter before a hearing examiner. If no appeal is filed, Ms. Rama would lose her license to operate the nursing home, located at 140 W. Lafayette St.
Mr. Sabatini said yesterday that his staff was already planning the transfer of the home's 211 patients to other nursing homes in the event the license is withdrawn. Other scenarios are possible, he said, including an arrangement under which Golden Touch would be allowed to keep its license so it could sell the business to more competent owners.
In the last inspection report, officials noted one particularly graphic incident in which doctors prescribed two -- and then three -- sedating drugs to a 76-year-old man whose dementia often made him physically and verbally abusive. Heavily drugged, the man fell three times in three days, cutting his hands and face, and in the last instance, breaking his hip.
Yesterday, Mr. Sabatini said that the decision to revoke the Golden Touch license was not based on any one incident. He also said he is weighing the additional step of disqualifying the home from receiving funds from the Medicaid program.
"It's been a consistent pattern of poor performance," he said. "They've failed four surveys in the last 12 months, all with the same problems, nursing and physician care. They seem totally incapable of addressing the problem and fixing the problem in a way that makes sure it stays fixed."