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    Patients won't have to relocate

    The state rescinds cancellation of contracts at three Vencor nursing homes in exchange for better care.

    By JEFF TESTERMAN

    © St. Petersburg Times, published October 19, 2000


    TAMPA -- In an unprecedented initiative earlier this month, the state announced it was singling out six of Florida's worst nursing homes, canceling their Medicaid contracts and ordering the relocation of 628 elderly or disabled patients.

    Wednesday, the state rescinded the cancellation of the contracts for three of the homes and entered into a "unique partnership" to guarantee quality care at the subpar nursing homes.

    The "partnership" resulted from a settlement between the owner of the three homes, Vencor Inc. of Louisville, Ky., and Florida's Agency for Health Care Administration. It came only after Vencor obtained a restraining order against the state and the sympathy of a federal judge.

    At a federal court hearing in Tampa last week, U.S. District Judge James D. Whittemore said he was inclined to believe state officials acted illegally by canceling the contracts at Vencor's three homes. The judge ordered the state back to court this week to defend its actions.

    Wednesday, in a hearing that lasted 10 minutes, both sides said they were putting the finishing touches on a settlement. By late afternoon, both sides said they had accepted an agreement that keeps Medicaid funding in place and requires immediate action to improve care in three of Vencor's 20 homes in Florida. The agreement does not extend to the other three homes operated by other companies.

    "The people who reside in these nursing homes are the most frail among us, and the degree and quality of care they receive is a direct reflection of our commitment to reaching out and helping those who cannot help themselves," Gov. Jeb Bush said in a statement. "I applaud Vencor's willingness to come to the table to improve the quality of care for our state's elders."

    Edward L. Kuntz, Vencor chairman and CEO, said the agreement reflects his company's commitment to quality care. Kuntz extended an invitation to any Medicaid patients already relocated to return to Vencor's facilities.

    An estimated one-third of 249 Medicaid patients at the three Vencor facilities have already moved.

    Wednesday's settlement returns state Medicaid funds to Vencor's Rehabilitation and HealthCare Center of Tampa, the Abbey Rehabilitation and Nursing Center in St. Petersburg and Colonial Oaks Rehabilitation in Fort Myers.

    The agreement still must be approved by a bankruptcy court because Vencor is in the midst of a Chapter 11 reorganization.

    The contracts were canceled Oct. 2 after the homes were repeatedly cited for poor patient care. State inspectors reported bed sores, residents languishing in wheelchairs, and unattended or overly medicated residents.

    Yet many residents interviewed after the contract cancellations praised the care they were receiving and questioned whether politics was behind the cancellations, a charge Bush denied.

    The settlement requires an immediate evaluation of the Vencor homes' ability to prevent and treat bed sores, reduce incidence of patient falls, prevent dehydration and monitor drug interactions for patients taking multiple medications. In addition, Vencor will provide additional clinical training at the three facilities and will face regular site visits by independent compliance monitors.

    Vencor had argued that the state's action Oct. 2 would irreparably harm not just the company, but also patients who would be traumatized by the sudden uprooting from familiar surroundings.

    Many patients and their families applauded Wednesday's settlement.

    Ann Green, a resident at the Abbey Rehabilitation and Nursing Center, can now stay at the place she calls home.

    "I'm overjoyed that I get to stay," said Green, who has lived at the center for about five years. "I didn't know what I was going to do when they said I had to move."

    Green, 85, was paralyzed on her left side by a stroke eight years ago. She can't walk. She doesn't have much family in the Tampa Bay area to assist with relocation.

    Like some other Medicaid patients in the area, a move for Green would mean that facility staff members would have to do the work. They would have to gather her belongings and transport them for her, she said.

    "I have been sitting here worrying about this, just waiting for someone to take me," Green said. "I'm so glad we can all calm down now. It would have been so much trouble."

    Others were upset with Bush and the state officials who urged the contracts be canceled.

    "I don't know what the man in Tallahassee was thinking when they did this," said Cathy Vetramo, whose 83-year-old bedridden mother is a Medicaid patient at the Rehabilitation and HealthCare Center in Tampa. "I think the state went too far."

    - Times staff writers Michael Sandler and Natalie Baughman contributed to this story.

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