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Nursing home acts to end fines

An inspection at Crystal River Health and Rehabilitation Center uncovered deficiencies that will result in daily fines until the problems are resolved.

By JIM ROSS

© St. Petersburg Times, published February 4, 2001


CRYSTAL RIVER -- State inspectors found plenty of problems last month when they visited the Crystal River Health and Rehabilitation Center. As a result, the state and federal governments have fined the nursing home $500 per day until the facility fixes the trouble.

Officials at the 150-bed nursing home immediately made changes after the Jan. 11 inspection. They submitted a formal corrective action plan Friday.

"We have worked very diligently with the state . . . to put an action plan in place and get the tags (deficiencies) corrected," said Marc Cornelius, regional manager for Northport Health Services, the Alabama company that owns Crystal River Health.

Cornelius said the company has not paid any fines yet. The state will keep track of what's owed. The fine will accrue until the state determines on what date Crystal River Health has achieved compliance.

The fine began accruing Jan. 12; it's possible the state, after reviewing the action plan and other records, might determine Crystal River became compliant relatively soon after that date.

During inspections, regulators with the state Agency for Health Care Administration look at patient charts, interview residents and staff and observe the surroundings. They are checking whether the home complies with state and federal laws.

Almost every nursing home and assisted living facility receives some type of citation during inspection. Typically, the state asks the home to train staff, correct the problems immediately and submit a plan that spells out what changes the facility will make to ensure future compliance.

During the Jan. 11 trip, however, inspectors found enough trouble that the state agency thought a fine was appropriate.

For example, regulators learned that a resident had been injured Nov. 7 when he fell from his wheelchair. This happened when a student volunteer who typically works in the kitchen was wheeling the man back into the home, records showed. The resident suffered bruises to his head, right eye and ribs.

"The school job coach was outside with the students and had instructed the student to slow down but was unable to prevent the student from pushing the wheelchair over the edge of the sidewalk," regulators wrote.

The state cited Crystal River Health for failing to adequately supervise the volunteer.

Inspectors also found fault elsewhere.

The facility did not properly investigate five of 14 incidents filed in its abuse log between June and December.

Inspectors observed a male resident wearing pajamas that were too small. His skin was exposed between the buttons on his pajama top and the fly was spread open, exposing his skin and groin.

Crystal River didn't provide care necessary to prevent two residents from developing ulcers.

Residents repeatedly complained about cold food and lack of bedtime snacks. One nursing aide even said the food trays typically sit 20 minutes before they are delivered to residents who eat in their rooms.

Payroll records and other documents showed the facility didn't have enough nursing aides on duty Dec. 24 and Dec. 30.

The federal Health Care Financing Administration, which administers Medicare, contracts with the state to inspect long-term care facilities and make certain they are complying with federal laws.

Considering the severity of the citations lodged after the Jan. 11 inspection, the federal government concurred with the state's decision to fine Crystal River Health, according to a letter the facility recently received.

The federal agency also notified Crystal River Health that it would deny payment for new admissions effective April 11 and terminate the facility from the Medicare and Medicaid programs on July 11 if the home doesn't come into compliance.

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