The state has halted the admission of patients to Northwest Nursing and Convalescent Center, citing the Pimlico-area nursing home for serious deficiencies in patient care.
"The deficiencies describe a nursing home where the conditions are deplorable," Health and Mental Hygiene Secretary Nelson J. Sabatini said yesterday.
The order was based on nine incidents in which the nursing home at 4601 Pall Mall Road in Baltimore violated the state health code. The violations include a failure to immediately notify doctors after residents became ill or had fallen. In one case, an 86-year-old patient went untreated for five hours after striking her head. Inspectors also cited improper monitoring of medication, lax monitoring of patients by physicians and a failure of the nursing staff to follow doctors' orders.
Mr. Sabatini issued an order Monday that prohibits the 91-bed facility from admitting new patients or readmitting patients who had been sent to hospitals.
Northwest, which has been cited numerous times in the past nine years for health and safety violations, has 21 days to correct the problems.
In one case cited by inspectors, a 74-year-old man suffering from dementia had been admitted with instructions that he be spoon-fed because he was unable to feed himself. But the staff failed to follow the instructions even though members of the staff noted on their reports that the man was not eating.
After three weeks, the patient was taken to a hospital suffering from dehydration. Not until that point was his doctor notified that the man had not been eating or drinking.
The home was also cited for negligence in allowing a 59-year-old man, suffering from schizophrenia, seizures and alcoholism, to wander the facility at will. Six times within a month he climbed a stairway onto the roof of the building. He fell down a set of stairs and received a black eye and a head cut.
Nursing home administrator Norman Karshmer said yesterday that the home "will correct the problems within the next two weeks."
"I think it's an excellent inner-city nursing home," he said. "I'm proud of the care Northwest provides and I'm not ashamed of anything we do."
The owners, Steven S. Diamond and Norman E. Pessin, bought Northwest in 1983, when it was called Pall Mall Nursing Home. Under their ownership, the nursing home has been cited over the years for deficiencies. Admissions at Northwest were banned twice -- in October 1984 and in January 1988 -- as a result of jTC health and safety violations. From July 1985 through October 1987, the nursing home operated under a state-imposed consent decree that Northwest's owners negotiated as an alternative to being closed.
The state has threatened at least four times to ban Northwest from the Medicaid program if it failed to improve conditions within a specified timetable. Medicaid certification is vital to the nursing home's survival because the expenses of the majority of its patients are paid for by the taxpayer-supported program.
The most recent action was taken in August 1989, when Northwest was cited for numerous health and safety violations and the state began proceedings to decertify participation in the Medicaid program. After a survey of conditions at the nursing home in November 1989, the state found Northwest to be in compliance and suspended the decertification proceedings.
After the most recent violations, inspectors will be visiting Northwest next month to verify corrective steps. At that time, the admissions ban could be lifted or extended, and proceedings could begin once more to deny Medicaid eligibility to the nursing home, state officials said.