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State uncovered many problems at Carriage Hill page 3
Unannounced inspections of Carriage Hill nursing home turned up 'actual-harm' citations by state

Date published: 5/24/2007

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A resident also was not receiving the "sitz" baths ordered by her surgeon. The surgeon wanted her hips and buttocks soaked in salt water three times a day to relieve the discomforts of surgery.

Employees apparently stopped giving her the baths when they decided that her surgical wounds were healed, according to the report. However, they did not notify her physician.

Seeking perfection

Termination from the Medicare program occurs somewhere in Virginia about once a year, said Stephen Morrisette, president of the Virginia Health Care Association, the trade group of nursing homes and assisted-living facilities.

The termination comes after six months of visits and revisits by state inspectors, who check 200 areas of concern, Morrisette said.

"Perfection is what they're looking for," he said. "There is very little forgiveness in the survey process."

After each inspection at Carriage Hill, MediCorp officials offered the state a "plan of correction," showing how they would improve operations at the home.

Officials promised added training and education for the staff, closer monitoring by nurse supervisors and better review of patient charts.

"In the past two weeks, we have made and continue to make significant changes to bring Carriage Hill back into regulatory compliance as soon as possible," said Kathleen Allenbaugh, MediCorp spokeswoman.

MediCorp officials assured residents last week that they can continue to live in the home and would not have to pay the costs now covered by Medicare or Medicaid.

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com


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What about staffing? The last four inspection reports for Carriage Hill Rehabilitation and Nursing Center do not mention the word "staffing."

State surveyors found fault with several aspects of Carriage Hill's operation, but they did not comment on whether the home had enough nurses and nurse assistants working there.

That's because neither the state nor the federal government sets staffing ratios for nursing homes.

"People want to pin the hat on staffing levels all the time," said Connie Kane, director of the division of long-term care for the Department of Health.

But staffing is one of "many, many things" that determines the quality of care offered by a nursing home, Kane said.

Just as important are the training and supervision of the staff and how much care the residents require, she said.

"I could find you a facility that had twice as much staff as the one down the street, but if they weren't well trained and they weren't well supervised, you might as well not have them in there," Kane said.

--Jim Hall