State forces Key Circle Hospice to close down BALTIMORE CITY

November 21, 1992|By Laura Lippman and Deborah Overton | Laura Lippman and Deborah Overton,Staff Writers

A city nursing home was forced to shut down yesterday after an administrative law judge ruled it was no longer in compliance with state Medicaid rules.

The 90-bed Key Circle Hospice, in the 1200 block of Eutaw Place, had been moving patients out this week in expectation of the judge's ruling. Yesterday, a day after the ruling came down, the state was finding new nursing homes for most of the remaining 70 patients, prompting a final flurry of moving expected to last through Tuesday.

Technically, state Administrative Law Judge Guy Avery did not order the nursing home to shut down. But, because virtually every patient there receives Medicaid from Maryland or the District of Columbia, the decertification forces Key Circle to close.

The 40 patients from Maryland will remain in the Baltimore area. But some of the Washington patients will end up as far away as Virginia Beach, Va., and Oakland in Western Maryland. The shutdown of the 24-year-old facility also leaves 120 employees without jobs, according to the owner, Dr. Richard Rigler.

Judge Avery ruled Thursday that a state inspection of Key Circle found a number of "level A" violations, the most serious on a three-tier scale. The violations included inadequate physician and nursing services.

Dr. Rigler said that the state was out to get him.

"I certainly do feel that the whole thing is like a vendetta," he said. "It's against the existence of Key Circle, it's my baby. . . . The paperwork is more important [to state officials] than the patients."

But state Secretary of Health and Mental Hygiene Nelson J. Sabatini said that Key Circle "had a long history of providing inadequate care."

"The issue here is that this was an inner-city nursing home, and there is a need for those facilities," Mr. Sabatini said. "But I was concerned about the adequacy of care. There is not going to be a separate standard of care for poor people in this state."

Mr. Sabatini said that the problems at Key Circle included poor communication among the nursing home's medical staff, which affected follow-up treatment of patients.

Patients would be tested for prostate cancer, for example, but never receive the results, Mr. Sabatini said.

Dr. Rigler said that patients received follow-ups after three months.

The state also said that evidence of abuse was found in an October survey of the facility, but Key Circle had not investigated those cases.

Judge Avery agreed in his order that there was a communications problem. But he added that that was being addressed and suggested that the state give the home another 90 days to get in compliance.

Mr. Sabatini said that that was beyond the judge's authority and declined to provide more time.

Shutting down nursing homes in Maryland is relatively rare. Typically, a home either gets into compliance or is sold.

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