LYNNE JETER

Following a crackdown on nursing home abuse, the Tennessee Department of Health Commissioner Susan R. Cooper, MSN, RN, suspended admissions to several nursing homes across the state in July and August based on deficiencies found during unannounced inspections. Special monitors will be appointed to review the centers’ operations.

Among them:

• The Cornelia House, a 159-bed licensed nursing home located at 701 Porter Road in Nashville. A state civil monetary penalty of $7,500 was imposed as a result of the facility being cited with immediate jeopardy level deficiencies for four sequential years since January 2003. The state also recommended that a federal civil penalty be imposed at $6,200 a day until the violations are corrected. The Cornelia House was ordered not to admit any new patients based on conditions found during a complaint investigation conducted June 27 through July 17. During the investigation, surveyors found violations of administration, quality of care, nursing services, resident protection and care planning standards. Specifically, the deficiencies related to failure of staff to implement and follow through with interventions to prevent resident elopement; failure to follow standards of practice to prevent aspiration in residents with feeding tubes; failure to develop and implement plans of care; and failure to provide for activities of daily living.

• Hermitage Health Center, a 70-bed licensed nursing home located at 1633 Hillview Drive in Elizabethton. A state civil monetary penalty of $1,500 was imposed. The state also recommended that a federal civil penalty be imposed at $3,550 a day until the violations are corrected. Hermitage Health Center was ordered not to admit any new patients based on conditions found during an annual survey conducted July 17-20. During the investigation, surveyors found violations of quality of care, nursing services, resident protection, physician’s orders and performance improvement standards. Specifically, the deficiencies related to failure of staff to ensure physician’s orders were followed; failure of the staff to obtain in a timely manner laboratory services; and failure of facility’s performance improvement committee to identify staff’s problems following physician’s orders and obtaining laboratory services.

• Ripley Healthcare and Rehabilitation Center, a 144-bed licensed nursing home located at 118 Halliburton Drive in Ripley. A state civil monetary penalty of $1,500 was imposed. The state also recommended that a federal civil penalty be imposed at $4,050 a day until the violations are corrected. Ripley Healthcare and Rehabilitation Center was ordered not to admit any new patients based on conditions found during an annual survey conducted Aug. 6-8. During the investigation, surveyors found violations of administration, resident protection, pharmacy, medication administration and physician’s orders standards. Specifically, the deficiencies relate to failure of staff to administer insulin according to physician orders; failure to put in place new interventions for residents with multiple falls resulting in fractures; failure of pharmacy to address or monitor Insulin administration; and failure to provide needed policy, procedures and staff in-services on insulin administration.

• Sun Valley Home for the Aged, a 15-bed licensed facility at 700 McMurray Boulevard in Hartsville. Admissions were suspended based on conditions found during a complaint investigation and annual survey conducted Aug. 2-13. During the investigation, surveyors found violations of resident protection, personal services, administration, life safety, environment, and resident records standards. Specifically, the deficiencies related to failure of administration and staff to ensure documentation of the following: administration of medications as prescribed by the physician; changes in the health status of the resident; current physician orders and orders for treatment of wounds; resident’s insurance; flu and pneumonia vaccine choices; a contact person for each resident; preference of healthcare providers; signed agreements; and home health services and their documentation. Additional deficiencies include failure of administration and staff to ensure the following: transfer and discharge information was contained in resident records and kept current; physician’s orders were followed for resident wound care; residents were free of communicable disease upon admission and during their residence; medications were administered as ordered; clean linens were in sufficient supply; facility physical environment was maintained in a safe, clean and sanitary manner throughout the facility; adequate lighting was provided to residents; physical environment was maintained to prevent pest infestation; food was stored at proper temperatures and posted menus were followed; and facility policies and procedures were in place as required.

• Adams Place, a 40-bed licensed nursing home located at 1927 Memorial Boulevard in Murfreesboro. A state civil monetary penalty of $1,500 was imposed, and the state also recommended that a federal civil penalty be imposed at $3,050 a day until the violations are corrected. The facility was ordered not to admit new patients based on conditions found during a complaint investigation conducted Aug. 9-13. During the investigation, surveyors found violations of administration, resident protection, performance improvement, quality of care, and notification of condition changes standards.

The Tennessee Department of Health suspended new admissions of patients to Bells Nursing Home, a 120-bed facility located at 260 Herndon Drive in Bells, in late June based on specific violation categories including quality of care, social services, administration, medical director and dental services. The deficiencies noted for the facility, owned and managed by Harber-Laman, related to failure of staff to follow through with recommendations of physical and contract dental service; failure of the medical director, administrator and social services to provide outside resources to alleviate medical need; and failure to protect a resident from harm.

“We inspect all licensed healthcare facilities annually, including nursing homes,” said Shelley Walker, spokesperson for the Tennessee Department of Health. “The survey visits are unannounced, and if we get a complaint there will be an additional survey.”

The commissioner may suspend admissions to a nursing home when conditions are determined to be, or are likely to be, detrimental to the health, safety or welfare of the residents. The order to suspend admissions remains effective until conditions have been and continue to remain corrected. A copy of the order must be posted at the public entrance where it can be plainly seen.

The nursing home has the right to a hearing regarding the suspension of admissions before the Board for Licensing Health Care Facilities or an administrative judge.



September 2007